Provider Demographics
NPI:1366045650
Name:CRUZ, JULIE (PHMNP-BC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:PHMNP-BC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:ASHCRAFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5410 POWERS CENTER PT STE 210
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5410 POWERS CENTER PT STE 210
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7148
Practice Address - Country:US
Practice Address - Phone:719-553-6924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996137-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty