Healthcare Provider Details

I. General information

NPI: 1518870864
Provider Name (Legal Business Name): NORMA L CRUZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 N JEFFERSON AVE
SPRINGFIELD MO
65802-1988
US

IV. Provider business mailing address

1423 N JEFFERSON AVE
SPRINGFIELD MO
65802-1988
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-3275
  • Fax: 417-269-8852
Mailing address:
  • Phone: 417-269-3275
  • Fax: 417-269-8852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number2009003280
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: