Provider Demographics
NPI:1174257422
Name:CRUZ, MARGOT MARIE (NP-C)
Entity type:Individual
Prefix:
First Name:MARGOT
Middle Name:MARIE
Last Name:CRUZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5528 N WOODSIDE CT
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-8026
Mailing Address - Country:US
Mailing Address - Phone:772-204-6549
Mailing Address - Fax:317-219-0879
Practice Address - Street 1:5528 N WOODSIDE CT
Practice Address - Street 2:
Practice Address - City:MCCORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46055-8026
Practice Address - Country:US
Practice Address - Phone:772-204-6549
Practice Address - Fax:317-219-0879
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71012668A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily