Provider Demographics
NPI:1174266928
Name:MILLAN AGUILAR, PERLA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:PERLA
Middle Name:
Last Name:MILLAN AGUILAR
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:PERLA
Other - Middle Name:
Other - Last Name:MILLAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:4851 INDEPENDENCE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6712
Mailing Address - Country:US
Mailing Address - Phone:303-425-0300
Mailing Address - Fax:
Practice Address - Street 1:4851 INDEPENDENCE ST STE 200
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6712
Practice Address - Country:US
Practice Address - Phone:303-425-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1208049363LP0808X
CO0997535363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health