| Doctor Name: | MARYPHYLLIS CREAN |
| NPI Number: | 1053781021 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | A.R.N.P. |
| License Number: | ARNP 9397131 |
| Business Practice Address: | 846 Lake Howell Rd Maitland, FL - 327515222 |
| Business Phone Number: | 4077672477 |
| Business Fax Number: | |
| Mailing Address: | 846 Lake Howell Rd, MAITLAND |
| State: | FL |
| Postal Code: | 327515222 |
| Phone Number: | 4077672477 |
| Fax Number: | |
| NPI Enumeration Date: | 10/02/2015 |
| NPI Last Update Date: | 10/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | ARNP 9397131 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |