Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 5281 | AK |
NPI | 1003987595 |
---|---|
Provider Name | Dr. Wendy Sue Cruz |
First Address | Anchorage, AK 99508-2961 |
Second Address | Anchorage, AK 99508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 16/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1015316 | (05) | AK |
I05146 | (02) | AK |