Individual
ELLEN GORDON POAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
13691 METRO PKWY STE 200, FORT MYERS, FL 33912-4321
(239) 264-1236
(321) 359-7055
Mailing address
6321 DANIELS PKWY STE 200, FORT MYERS, FL 33912-4710
(239) 416-8101
(239) 402-8601
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN1812112
FL
363L00000X
Nurse Practitioner
Primary
ARNP1812112
FL
363LF0000X
Family Nurse Practitioner
APRN1812112
FL
363LF0000X
Family Nurse Practitioner
ARNP1812112
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235753
WELLCARE
FL
01
—
398633
AVMED
FL
01
—
5034309
AETNA
FL
01
—
P01279998
RAILROAD MCR
FL
01
—
P959926
OPTIMUM
FL
01
—
P999557
FREEDOM
FL
01
—
Y4971
BCBS OF FL
FL
Enumeration date
07/11/2007
Last updated
06/23/2026
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