| Isai Cruz, FNP | |
|
209 Beasley St, Kenansville, NC 28349-8727 | |
| (540) 769-3964 | |
| (540) 473-3458 |
| Full Name | Isai Cruz |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 209 Beasley St, Kenansville, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366276495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 5020757 (North Carolina) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 5020757 (North Carolina) | Primary |
| Entity Name | Pai Participant 29 Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245813757 PECOS PAC ID: 6002216215 Enrollment ID: O20210609002615 |
| Entity Name | Universal Health Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407117625 PECOS PAC ID: 5597912626 Enrollment ID: O20230124003094 |
| Mailing Address | Practice Location Address |
|---|---|
| Isai Cruz, FNP 130 Church Ave Sw, Roanoke, VA 24011-1906 Ph: (540) 769-3964 | Isai Cruz, FNP 209 Beasley St, Kenansville, NC 28349-8727 Ph: (540) 769-3964 |
John Adam Lanier, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 401 N Main St, Kenansville, NC 28349 Phone: 910-296-0941 | |
Felice Noel Carlton, DNP, RN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 340 Seminary St, Kenansville, NC 28349 Phone: 910-296-2130 Fax: 910-296-0252 | |
Dr. Susan Elizabeth Fawcett, DNP, APRN, CPNP-PC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 144 Liberty Square Shopping Center, Kenansville, NC 28349 Phone: 910-275-0060 | |
Mrs. Brittany Mobley Rich, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 401 North Main Street, Kenansville, NC 28349 Phone: 910-296-2790 | |
Mrs. Veronica Frederick Stevens, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 340 Seminary Street, Kenansville, NC 28349 Phone: 910-296-2130 | |
Mrs. Lecia Wooten Reardon, NP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 340 Seminary St, Kenansville, NC 28349 Phone: 910-296-2130 Fax: 910-296-0252 |