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NPI Code Detail

MEDICARE: MS. JACINTA FAYO CRUZ APN

MEDICARE:  MS. JACINTA FAYO CRUZ  APN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerTAPN700839NV
2363LF0000XFamily Nurse PractitionerAPRN001459NV
3363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN001459NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588908628
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JACINTA FAYO CRUZ APN
Provider Business Mailing Address
First Line : 11035 LAVENDER HILL DR STE 160-441
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-2955
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5536 S FORT APACHE RD STE 102
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-7687
Country : US
Telephone Number : 702-915-7001
Fax Number : 702-909-9254
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2012
Last Update Date : 07/10/2020

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Directions to “ MS. JACINTA FAYO CRUZ APN” Practice Location

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