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Individual

AMY NICOLE CREWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
820 PRUDENTIAL DR STE 304, JACKSONVILLE, FL 32207-8205
(904) 202-3860
(904) 202-3846
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-1032
(904) 376-4107

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9252750
FL
363LF0000X
Family Nurse Practitioner
APRN9252750
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
45681
MEDICARE - GROUP
FL
01
FF682Z
MEDICARE - INDIVIDUAL
FL
01
P00967414
RR MEDICARE
FL
01
Y0F17
FLORIDA BLUE
FL
Enumeration date
07/20/2011
Last updated
06/01/2023
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