Provider Demographics
NPI:1104513910
Name:CRUZ, BRITTNY ANN
Entity type:Individual
Prefix:
First Name:BRITTNY
Middle Name:ANN
Last Name:CRUZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 S BENSON ST
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-4403
Mailing Address - Country:US
Mailing Address - Phone:580-649-9648
Mailing Address - Fax:
Practice Address - Street 1:218 W CYPRESS ST
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-3704
Practice Address - Country:US
Practice Address - Phone:580-481-8760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist