Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0207X | Pediatric Hematology-Oncologist | A-1964-16 | NM |
Y | 2080P0207X | Pediatric Hematology-Oncologist | DO2857 | NV |
NPI | 1104140086 |
---|---|
Provider Name | Amy Cruickshank |
First Address | Las Vegas, NV 89147-8465 |
Second Address | Las Vegas, NV 89135-3011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2010 |
Last Update Date | 05/11/2021 |