Provider Demographics
NPI:1982242244
Name:DUQUE, AARON JIMENEZ (RN)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:JIMENEZ
Last Name:DUQUE
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 1:911 VIA VERDE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-7025
Mailing Address - Country:US
Mailing Address - Phone:619-502-1456
Mailing Address - Fax:
Practice Address - Street 1:2391 BOSWELL RD
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-3509
Practice Address - Country:US
Practice Address - Phone:619-397-0939
Practice Address - Fax:619-421-4907
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95070652163WE0003X, 163WR0400X, 163WD1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD1100XNursing Service ProvidersRegistered NurseDialysis, PeritonealGroup - Multi-Specialty
No163WE0003XNursing Service ProvidersRegistered NurseEmergencyGroup - Multi-Specialty
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation