Provider Demographics
NPI:1194615179
Name:CRESWICK, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:CRESWICK
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 1:2815 E MALLORY BLVD
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8414
Mailing Address - Country:US
Mailing Address - Phone:561-351-1446
Mailing Address - Fax:
Practice Address - Street 1:2815 E MALLORY BLVD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-8414
Practice Address - Country:US
Practice Address - Phone:561-351-1446
Practice Address - Fax:561-351-1446
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11039506363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner