Provider Demographics
NPI:1366772782
Name:CRUZ, BERNADINE L (APRNCNP)
Entity type:Individual
Prefix:
First Name:BERNADINE
Middle Name:L
Last Name:CRUZ
Suffix:
Gender:F
Credentials:APRNCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-6255
Mailing Address - Fax:614-293-1456
Practice Address - Street 1:3721 RIDGE MILL DR FL 1
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9554
Practice Address - Country:US
Practice Address - Phone:614-293-6255
Practice Address - Fax:614-293-1456
Is Sole Proprietor?:No
Enumeration Date:2010-01-07
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDF0616274363LF0000X
OHAPRN.CNP.019596363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty