| Doctor Name: | TRACEY CRUZ |
| NPI Number: | 1508224163 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN-63948 |
| Business Practice Address: | 2240 Winrow Ave Usa Meddac Rwbahc Fort Huachuca, AZ - 85613 |
| Business Phone Number: | 5205339034 |
| Business Fax Number: | 5205335148 |
| Mailing Address: | 2240 Winrow Ave, Usa Meddac Rwbahc FORT HUACHUCA |
| State: | AZ |
| Postal Code: | 85613 |
| Phone Number: | 5205339034 |
| Fax Number: | 5205335148 |
| NPI Enumeration Date: | 02/10/2016 |
| NPI Last Update Date: | 02/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP2201X |
| License Number: | RN-63948 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | HI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Ambulatory Care |
| Taxonomy Definition: | |