Healthcare Provider Details

I. General information

NPI: 1477240240
Provider Name (Legal Business Name): MELISSA CRUCE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7125 UNIVERSITY CT
MONTGOMERY AL
36117-8016
US

IV. Provider business mailing address

88 WOODRIDGE AVE
PIKE ROAD AL
36064-3888
US

V. Phone/Fax

Practice location:
  • Phone: 334-239-2622
  • Fax:
Mailing address:
  • Phone: 205-999-6907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-185624
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number1-185624
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: