Provider Demographics
NPI:1164826558
Name:WIGGINS-AGUILAR, GLORIA DEAN (MSN,APRN,FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:DEAN
Last Name:WIGGINS-AGUILAR
Suffix:
Gender:F
Credentials:MSN,APRN,FNP-C
Other - Prefix:MRS
Other - First Name:GLORIA
Other - Middle Name:DEAN
Other - Last Name:WIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN, FNP-C
Mailing Address - Street 1:10817 W 76TH ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66214-2933
Mailing Address - Country:US
Mailing Address - Phone:913-558-8712
Mailing Address - Fax:
Practice Address - Street 1:4055 VALLEY VIEW LN STE 700
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5045
Practice Address - Country:US
Practice Address - Phone:405-459-7016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75517363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner