Provider Demographics
NPI:1336511476
Name:ESPARZA, CARLOS JUSTIN AGUON (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:JUSTIN AGUON
Last Name:ESPARZA
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 S DECATUR BLVD STE GH
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-4934
Mailing Address - Country:US
Mailing Address - Phone:775-477-2273
Mailing Address - Fax:
Practice Address - Street 1:5010 S DECATUR BLVD STE G
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-4935
Practice Address - Country:US
Practice Address - Phone:702-501-5263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002062363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner