Provider Demographics
NPI:1083244123
Name:AGUILAR-MARTINEZ, REYNA SILVIA (APRN)
Entity Type:Individual
Prefix:
First Name:REYNA
Middle Name:SILVIA
Last Name:AGUILAR-MARTINEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:LIBERAL
Mailing Address - State:KS
Mailing Address - Zip Code:67901-2784
Mailing Address - Country:US
Mailing Address - Phone:620-624-2565
Mailing Address - Fax:620-624-3016
Practice Address - Street 1:102 E 11TH ST
Practice Address - Street 2:
Practice Address - City:LIBERAL
Practice Address - State:KS
Practice Address - Zip Code:67901-2784
Practice Address - Country:US
Practice Address - Phone:620-624-2565
Practice Address - Fax:620-624-3016
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-79082-062363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology