Provider Demographics
NPI:1730651753
Name:JIMENEZ AGUILAR, ALVARO JESUS (RN)
Entity Type:Individual
Prefix:MR
First Name:ALVARO
Middle Name:JESUS
Last Name:JIMENEZ AGUILAR
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1764 SILVER BELL RD
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1146
Mailing Address - Country:US
Mailing Address - Phone:952-500-0593
Mailing Address - Fax:
Practice Address - Street 1:1764 SILVER BELL RD
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122
Practice Address - Country:US
Practice Address - Phone:952-500-0593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2445809163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse