Provider Demographics
NPI:1821338575
Name:GONZALEZ-CRUZ, CARMEN (RN, MSN, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:
Last Name:GONZALEZ-CRUZ
Suffix:
Gender:F
Credentials:RN, MSN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 NORTHSHORE DR
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-5159
Mailing Address - Country:US
Mailing Address - Phone:956-778-4481
Mailing Address - Fax:
Practice Address - Street 1:4770 N EXPRESSWAY # 83
Practice Address - Street 2:SUITE 102
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-4165
Practice Address - Country:US
Practice Address - Phone:956-778-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-17
Last Update Date:2013-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX670592363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics