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General NPI Number Information
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NPI Number | 1063743961
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Entity Type | Individual
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Provider Name | SUSAN LEWIS CRUZ NP
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Gender | Female
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Dates
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Enumeration Date | 01/18/2010
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 30 CHASE AVE WORKPLACE HEALTH
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City | WATERVILLE
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State | ME
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Zip | 04901-4624
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Country | US
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Telephone | 207-872-4260
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Fax | 207-872-4034
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Provider Business Mailing Address
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Address Line | 2 CARLE ST APT 21
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City | WATERVILLE
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State | ME
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Zip | 04901-5172
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Country | US
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Telephone | 207-660-6601
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP101004
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN1002135
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AC000471
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License Number State | MD
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