Provider Demographics
NPI:1073844940
Name:ESPINOSA, AGNES (MSN, CCRN, ACNP-BC)
Entity Type:Individual
Prefix:MS
First Name:AGNES
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:MSN, CCRN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CLENT RD
Mailing Address - Street 2:APT H
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3460
Mailing Address - Country:US
Mailing Address - Phone:516-298-6152
Mailing Address - Fax:
Practice Address - Street 1:177 FORT WASHINGTON AVE
Practice Address - Street 2:MHB 5 GARDEN NORTH ROOM 5-435
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3733
Practice Address - Country:US
Practice Address - Phone:516-298-6152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430445-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care