Individual
LORI BETH CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5735 DURAND AVE, MOUNT PLEASANT, WI 53406-5011
(262) 598-1392
Mailing address
7312 35TH AVE, KENOSHA, WI 53142-7201
(262) 676-9977
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
325785
WI
Other
Enumeration date
03/18/2021
Last updated
03/18/2021
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