Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP30004207 | WA |
NPI | 1134232606 |
---|---|
Provider Name | Mrs. Heather Anne Cruz |
First Address | Lacey, WA 98503-4062 |
Second Address | Seattle, WA 98105-5653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 08/07/2007 |