Healthcare Provider Details

I. General information

NPI: 1780372771
Provider Name (Legal Business Name): ALICIA CRITCHER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEMORIAL MEDICAL PKWY STE 101
PALM COAST FL
32164-5979
US

IV. Provider business mailing address

1 MEMORIAL MEDICAL PKWY STE 101
PALM COAST FL
32164-5979
US

V. Phone/Fax

Practice location:
  • Phone: 386-586-1523
  • Fax: 386-445-4751
Mailing address:
  • Phone: 386-586-1523
  • Fax: 386-445-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP11026022
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11026022
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: