Provider Demographics
NPI:1689019044
Name:CRUZ MORALES, ESMERARDO (FNP NP-C)
Entity type:Individual
Prefix:
First Name:ESMERARDO
Middle Name:
Last Name:CRUZ MORALES
Suffix:
Gender:M
Credentials:FNP NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 BUFORD HWY NE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-1003
Mailing Address - Country:US
Mailing Address - Phone:678-521-1624
Mailing Address - Fax:404-636-8286
Practice Address - Street 1:4300 BUFORD HWY NE
Practice Address - Street 2:SUITE 216
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-1003
Practice Address - Country:US
Practice Address - Phone:404-636-8282
Practice Address - Fax:404-636-8286
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN219464363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily