Provider Demographics
NPI:1083618045
Name:CRUCE, ALICIA ANN (MD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:ANN
Last Name:CRUCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:ANN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7001 A ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4201
Mailing Address - Country:US
Mailing Address - Phone:402-489-0800
Mailing Address - Fax:402-489-6803
Practice Address - Street 1:7001 A ST
Practice Address - Street 2:SUITE 110
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4201
Practice Address - Country:US
Practice Address - Phone:402-489-0800
Practice Address - Fax:402-489-6803
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22377208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics