Provider Demographics
NPI:1467225383
Name:CRUZ, ANAHI (LPN)
Entity Type:Individual
Prefix:
First Name:ANAHI
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ANAHI
Other - Middle Name:
Other - Last Name:SORIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:11429 W MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-1129
Mailing Address - Country:US
Mailing Address - Phone:480-510-6408
Mailing Address - Fax:
Practice Address - Street 1:7025 N SCOTTSDALE RD STE 200
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-3675
Practice Address - Country:US
Practice Address - Phone:602-385-8733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ236149164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse