Provider Demographics
NPI:1932946191
Name:DELA CRUZ, GIANRHINA STEPHIE MARIN
Entity type:Individual
Prefix:
First Name:GIANRHINA STEPHIE
Middle Name:MARIN
Last Name:DELA CRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 AMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:OAK GROVE
Mailing Address - State:KY
Mailing Address - Zip Code:42262-8364
Mailing Address - Country:US
Mailing Address - Phone:808-796-4739
Mailing Address - Fax:
Practice Address - Street 1:124 AMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:OAK GROVE
Practice Address - State:KY
Practice Address - Zip Code:42262-8364
Practice Address - Country:US
Practice Address - Phone:808-796-4739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-13
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY50259729376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide