Provider Demographics
NPI:1134618804
Name:ALICEA, NIKITA (CRNP)
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:
Last Name:ALICEA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:NIKITA
Other - Middle Name:
Other - Last Name:LAMASHERPA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:352-567-0188
Mailing Address - Fax:813-355-5101
Practice Address - Street 1:38021 MARKET SQUARE DR
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-7504
Practice Address - Country:US
Practice Address - Phone:813-771-5037
Practice Address - Fax:813-355-5090
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018688363L00000X
FLAPRN11017921363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner