Provider Demographics
NPI:1558963447
Name:CRUZ MENDEZ, ADRIANNY
Entity Type:Individual
Prefix:
First Name:ADRIANNY
Middle Name:
Last Name:CRUZ MENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 STEARNS AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-1148
Mailing Address - Country:US
Mailing Address - Phone:978-736-9001
Mailing Address - Fax:
Practice Address - Street 1:107 STEARNS AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-1148
Practice Address - Country:US
Practice Address - Phone:978-736-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2345969163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse