Provider Demographics
NPI:1124504477
Name:ARAGON, MARIA MONICA (FNP-C)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MONICA
Last Name:ARAGON
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 1:5813 BRILLIANT BLUE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3719
Mailing Address - Country:US
Mailing Address - Phone:702-355-2668
Mailing Address - Fax:
Practice Address - Street 1:3000 W CHARLESTON BLVD STE 6
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1940
Practice Address - Country:US
Practice Address - Phone:702-878-5252
Practice Address - Fax:702-878-1963
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV811583363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1124504477Medicaid