Provider Demographics
NPI:1518718675
Name:CREWS, ERIN MACKENZIE
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MACKENZIE
Last Name:CREWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23715 NE HIGHWAY 314
Mailing Address - Street 2:
Mailing Address - City:SALT SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32134-6239
Mailing Address - Country:US
Mailing Address - Phone:352-414-1644
Mailing Address - Fax:
Practice Address - Street 1:23715 NE HIGHWAY 314
Practice Address - Street 2:
Practice Address - City:SALT SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32134-6239
Practice Address - Country:US
Practice Address - Phone:352-414-1644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029657363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily