| NPI | 1699019372 |
|---|---|
| Former Name | KELLYE RAYANN CRUZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP122572) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 723439) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2021-12-23 |