MEDICARE: ALICA MCCALUP NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	280891	AZ

General Provider Information

NPI Number	:	1538047212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICA MCCALUP NP

Provider Business Mailing Address
First Line	:	11047 N 19TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4816
Country	:	US
Telephone Number	:	602-589-0500
Fax Number	:	602-314-4552

Provider Business Practice Location Address
First Line	:	10000 N 31ST AVE STE D119
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-9587
Country	:	US
Telephone Number	:	928-460-8476
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2025
Last Update Date	:	03/05/2026

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