Provider Demographics
NPI:1942832167
Name:AGUILAR, MARCELA (FNP-C)
Entity Type:Individual
Prefix:
First Name:MARCELA
Middle Name:
Last Name:AGUILAR
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 1:2908 PINO SECO PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2707
Mailing Address - Country:US
Mailing Address - Phone:915-274-2269
Mailing Address - Fax:
Practice Address - Street 1:11355 MONTWOOD DR STE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-3883
Practice Address - Country:US
Practice Address - Phone:915-849-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144775363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner