Provider Demographics
NPI:1427364868
Name:CRUZ, JESSICA A (APN, RN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:CRUZ
Suffix:
Gender:F
Credentials:APN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5876 S PECOS RD
Mailing Address - Street 2:BLDG. B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3418
Mailing Address - Country:US
Mailing Address - Phone:702-733-0744
Mailing Address - Fax:702-796-8262
Practice Address - Street 1:5876 S PECOS RD
Practice Address - Street 2:BLDG. B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3418
Practice Address - Country:US
Practice Address - Phone:702-733-0744
Practice Address - Fax:702-796-8262
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001220363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily