Provider Demographics
NPI:1427628353
Name:AGUILAR, EILEEN (NP-C)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15640 N 28TH DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-4059
Mailing Address - Country:US
Mailing Address - Phone:602-595-7841
Mailing Address - Fax:602-978-5233
Practice Address - Street 1:8908 W MAUI LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-3703
Practice Address - Country:US
Practice Address - Phone:757-234-1825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZF05210060363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily