Provider Demographics
NPI:1093435869
Name:CRUZ, KATIE STANDRIDGE (APRN)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:STANDRIDGE
Last Name:CRUZ
Suffix:
Gender:F
Credentials:APRN
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9662
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72033-9662
Mailing Address - Country:US
Mailing Address - Phone:501-852-1363
Mailing Address - Fax:501-852-1364
Practice Address - Street 1:2302 COLLEGE AVE STE 200
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-6297
Practice Address - Country:US
Practice Address - Phone:501-513-5385
Practice Address - Fax:501-513-5257
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2025-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AR2211872080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine