Organization
LIFT VITALIZE & RESTORE PSYCHIATRIC SERVICES PLLC
Active
Organization
LIFT VITALIZE & RESTORE PSYCHIATRIC SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEDIA N DELUA-RUIZ PMHNP-BC (PSYCHIATRIC NURSE PRACTITIONER)
(361) 960-2392
Entity
Organization
Contact information
Practice address
6625 WOOLDRIDGE RD, 101, CORPUS CHRISTI, TX 78414-2916
(361) 356-6441
(361) 356-6565
Mailing address
6625 WOOLDRIDGE RD, 101, CORPUS CHRISTI, TX 78414-2916
(361) 356-6441
(361) 356-6565
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
AP132546
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992247803
NPI NUMBER
TX
Enumeration date
12/21/2016
Last updated
12/21/2016
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