Provider Demographics
NPI:1295078335
Name:AINA, FUNMILAYO (DNP, CNP)
Entity type:Individual
Prefix:DR
First Name:FUNMILAYO
Middle Name:
Last Name:AINA
Suffix:
Gender:F
Credentials:DNP, CNP
Other - Prefix:MS
Other - First Name:FUNMILAYO
Other - Middle Name:
Other - Last Name:CROWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PECOS VALLEY MEDICAL CENTER
Mailing Address - Street 2:199 HWY 50
Mailing Address - City:PECOS
Mailing Address - State:NM
Mailing Address - Zip Code:87552
Mailing Address - Country:US
Mailing Address - Phone:505-757-6482
Mailing Address - Fax:
Practice Address - Street 1:PECOS VALLEY MEDICAL CENTER
Practice Address - Street 2:199 HWY 50
Practice Address - City:PECOS
Practice Address - State:NM
Practice Address - Zip Code:87552
Practice Address - Country:US
Practice Address - Phone:505-757-6482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM55817363LP2300X, 363LF0000X
TXAP123182363LF0000X, 363LP2300X
TX688447363LP2300X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM45827036Medicaid
TX341049006Medicaid