Provider Demographics
NPI:1134970205
Name:CRUZ, CAMILL ENID (MSN)
Entity type:Individual
Prefix:MRS
First Name:CAMILL
Middle Name:ENID
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9474
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-9474
Mailing Address - Country:US
Mailing Address - Phone:787-501-6592
Mailing Address - Fax:
Practice Address - Street 1:CARR 172 CANABONCITO
Practice Address - Street 2:KM 4.2
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-501-6592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR81111163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health