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NPI Code Detail

MEDICARE: STACI ANN CRUZ PA C

MEDICARE: STACI ANN CRUZ 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
1363AM0700XMedical Physician Assistant2215AZ

General Provider Information

NPI Number : 1235332990
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACI ANN CRUZ PA C
Provider Business Mailing Address
First Line : 6285 S HIGLEY RD
Second Line :
City : GILBERT
State : AZ
Zip : 85298-4262
Country : US
Telephone Number : 480-460-4949
Fax Number : 480-460-5858
Provider Business Practice Location Address
First Line : 6285 S HIGLEY RD
Second Line :
City : GILBERT
State : AZ
Zip : 85298-4262
Country : US
Telephone Number : 480-460-4949
Fax Number : 480-460-5858
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2007
Last Update Date : 07/29/2020

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Directions to “ STACI ANN CRUZ PA C” Practice Location

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