Individual
TRACEY K. CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3359 WALLHAVEN CT, CROWN POINT, IN 46307-8920
(219) 308-4388
Mailing address
3359 WALLHAVEN CT, CROWN POINT, IN 46307-8920
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27045242A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27045242A
NURSING LICENSE
IN
Enumeration date
05/06/2026
Last updated
05/06/2026
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