Provider Demographics
NPI:1194329573
Name:CRUZ, ELIZABETH N (FNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:N
Last Name:CRUZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:RAMAH
Mailing Address - State:CO
Mailing Address - Zip Code:80832-0034
Mailing Address - Country:US
Mailing Address - Phone:228-313-5688
Mailing Address - Fax:
Practice Address - Street 1:2875 INTERNATIONAL CIR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3144
Practice Address - Country:US
Practice Address - Phone:719-389-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0994939207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty