Provider Demographics
NPI:1518668847
Name:AGUILAR, ERIC ANTHONY (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:ANTHONY
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 WILLOW OAK LN APT 103
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3130
Mailing Address - Country:US
Mailing Address - Phone:915-799-4572
Mailing Address - Fax:
Practice Address - Street 1:65 MURRAY GUARD DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3628
Practice Address - Country:US
Practice Address - Phone:731-300-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33589363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health