Basic Information
| Provider Information | |||||||||
| NPI: | 1386089894 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRUZ | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | MELISSA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPARTMENT OF PSYCHIATRY CB # 7160 101 MANNING DRIVE | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9849743237 | ||||||||
| FaxNumber: | 9849749646 | ||||||||
| Practice Location | |||||||||
| Address1: | DEPARTMENT OF PSYCHIATRY CLB | ||||||||
| Address2: | 101 MANNING DRIVE | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27599 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199664764 | ||||||||
| FaxNumber: | 9199669646 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2013 | ||||||||
| LastUpdateDate: | 08/29/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 191586 | NC | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2084P0804X | 191586 | NC | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.