=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831473800
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARMANDO LEE CRUZ FNP-C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2011
-----------------------------------------------------
Last Update Date | 06/01/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2321 PYRAMID WAY
-----------------------------------------------------
City | SPARKS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89431-8716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-900-3913
-----------------------------------------------------
Fax | 775-391-3239
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2321 PYRAMID WAY
-----------------------------------------------------
City | SPARKS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89431-8716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-900-3913
-----------------------------------------------------
Fax | 775-391-3239
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 818951
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------