Genevieve La Fannie Cruz | Layton, UT • PECOS Search

Genevieve La Fannie Cruz

Community Health Worker

Other Service Providers

934 S Main St, Layton, UT 84041-7135

PECOS Enrollment

Based on the most recent information from CMS, provider Genevieve La Fannie Cruz does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:51 AM.

Profile Details

Provider ID
1003596362
Provider Type
Individual
Full Name
Cruz, Genevieve La Fannie
Gender
Female

Sole Proprietor
Yes
Enumeration Date
7/21/2023
Last Updated
7/21/2023

Contact Information

Practice Location

934 S Main St, Layton, UT 84041-7135

Unlisted Fax

Mailing Location

934 S Main St, Layton, UT 84041-7135

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 172V00000X Primary	Description Community Health Worker Other Service Providers	License Unlisted Issuer