Healthcare Provider Details

I. General information

NPI: 1093606576
Provider Name (Legal Business Name): ALICIA CREWS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2025
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

944 DELTONA BLVD UNIT 5196
DELTONA FL
32728-7410
US

IV. Provider business mailing address

944 DELTONA BLVD UNIT 5196
DELTONA FL
32728-7410
US

V. Phone/Fax

Practice location:
  • Phone: 386-272-2913
  • Fax: 386-590-9186
Mailing address:
  • Phone: 386-272-2913
  • Fax: 386-590-9186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11041057
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2771171
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: