Healthcare Provider Details

I. General information

NPI: 1053226704
Provider Name (Legal Business Name): JOSIAH R CRUZ PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

5325 PRINGLE WAY
HOPE MILLS NC
28348-5203
US

IV. Provider business mailing address

5325 PRINGLE WAY
HOPE MILLS NC
28348-5203
US

V. Phone/Fax

Practice location:
  • Phone: 910-922-6141
  • Fax:
Mailing address:
  • Phone: 910-922-6141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2026024924
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: