MEDICARE: ERIN CRUISE PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	MA064325	PA

General Provider Information

NPI Number	:	1043926926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN CRUISE PA-C

Provider Business Mailing Address
First Line	:	416 WINDY TOR RD
Second Line	:
City	:	LEOLA
State	:	PA
Zip	:	17540-1240
Country	:	US
Telephone Number	:	717-945-9030
Fax Number	:

Provider Business Practice Location Address
First Line	:	2160 STATE RD
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-1812
Country	:	US
Telephone Number	:	223-287-9000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2023
Last Update Date	:	04/06/2026

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Directions to “ ERIN CRUISE PA-C” Practice Location

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