Individual
MRS. ELLAGENE ELIZABETH CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1602 SW 82ND ST, LAWTON, OK 73505-9012
(580) 536-0077
Mailing address
1602 SW 82ND ST, LAWTON, OK 73505-9012
(580) 536-0077
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
50933
OK
Other
Enumeration date
12/19/2012
Last updated
12/19/2012
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