Provider Demographics
NPI:1639875024
Name:AGUIRRE, NIKOLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:NIKOLE
Middle Name:
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 W MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-2333
Mailing Address - Country:US
Mailing Address - Phone:559-972-3187
Mailing Address - Fax:
Practice Address - Street 1:510 W OAK AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-6039
Practice Address - Country:US
Practice Address - Phone:559-334-3871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95024166363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner