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General NPI Number Information
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NPI Number | 1942573522
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Entity Type | Individual
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Provider Name | YOSELY KATHY CRUZ-FERNANDEZ ACNP, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 02/13/2012
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 1710 HARPER RD
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City | BECKLEY
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State | WV
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Zip | 25801-3397
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Country | US
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Telephone | 559-260-7911
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Fax |
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Provider Business Mailing Address
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Address Line | 1157 DRY HILL RD
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City | BECKLEY
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State | WV
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Zip | 25801-2109
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Country | US
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Telephone | 559-260-7911
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 4704232812
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN88151
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN88151
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License Number State | WV
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