Provider Demographics
NPI:1538047212
Name:MCCALUP, ALICA (NP)
Entity type:Individual
Prefix:
First Name:ALICA
Middle Name:
Last Name:MCCALUP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 N 31ST AVE STE D119
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-9587
Mailing Address - Country:US
Mailing Address - Phone:602-742-0370
Mailing Address - Fax:928-460-8476
Practice Address - Street 1:10000 N 31ST AVE STE D119
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-9587
Practice Address - Country:US
Practice Address - Phone:928-460-8476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ280891363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health