Healthcare Provider Details

I. General information

NPI: 1174285324
Provider Name (Legal Business Name): HANNAH FAITH CRUZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH FAITH HALL

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1354 BULL LEA RD
LEXINGTON KY
40511-1247
US

IV. Provider business mailing address

1354 BULL LEA RD
LEXINGTON KY
40511-1247
US

V. Phone/Fax

Practice location:
  • Phone: 859-562-3899
  • Fax: 859-257-6200
Mailing address:
  • Phone: 859-562-3899
  • Fax: 859-257-6200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3016103
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3016103
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024181626
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: