| Doctor Name: | CAROL ANN CRUISE, PHN |
| NPI Number: | 1992924971 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, PHN, BSN |
| License Number: | RN 139146 |
| Business Practice Address: | 1175 Bel Arbres Dr Redwood Valley, CA - 954709695 |
| Business Phone Number: | 7074850129 |
| Business Fax Number: | |
| Mailing Address: | 1175 Bel Arbres Dr, REDWOOD VALLEY |
| State: | CA |
| Postal Code: | 954709695 |
| Phone Number: | 7074850129 |
| Fax Number: | |
| NPI Enumeration Date: | 04/25/2007 |
| NPI Last Update Date: | 02/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | RN 139146 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |