Provider Demographics
NPI:1982926747
Name:DELA CRUZ, LILEN LIWANAG (RN)
Entity Type:Individual
Prefix:MRS
First Name:LILEN
Middle Name:LIWANAG
Last Name:DELA CRUZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 417 BOX 5258
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09075-0003
Mailing Address - Country:US
Mailing Address - Phone:0980-295-3265
Mailing Address - Fax:
Practice Address - Street 1:US ARMY HEALTH CLINIC KATTERBACH
Practice Address - Street 2:CMR454
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09250
Practice Address - Country:US
Practice Address - Phone:0980-283-3303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA702892163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse