Healthcare Provider Details

I. General information

NPI: 1275456642
Provider Name (Legal Business Name): JALA ANEA CREWS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 SEMINOLE RD STE 200B
NORTON SHORES MI
49444-3747
US

IV. Provider business mailing address

339 AMITY AVE
MUSKEGON MI
49442-3255
US

V. Phone/Fax

Practice location:
  • Phone: 231-777-2222
  • Fax: 231-777-2066
Mailing address:
  • Phone: 231-769-5284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: