Provider Demographics
NPI:1760825202
Name:AQUINO, NIDJAN C (NP)
Entity Type:Individual
Prefix:MRS
First Name:NIDJAN
Middle Name:C
Last Name:AQUINO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8191 BROOK RD STE MN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-1334
Mailing Address - Country:US
Mailing Address - Phone:804-596-5320
Mailing Address - Fax:877-880-0211
Practice Address - Street 1:8191 BROOK RD STE MN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1334
Practice Address - Country:US
Practice Address - Phone:804-596-5320
Practice Address - Fax:877-880-0211
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170699363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health