Provider Demographics
NPI:1962376608
Name:AGUILAR, HEAVEN ROSE (RN)
Entity type:Individual
Prefix:
First Name:HEAVEN
Middle Name:ROSE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W ENTIAT AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-3046
Mailing Address - Country:US
Mailing Address - Phone:509-222-0920
Mailing Address - Fax:
Practice Address - Street 1:2500 W ENTIAT AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3046
Practice Address - Country:US
Practice Address - Phone:509-222-0920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-04
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61059726163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice