NPI 1063904662 · live from the CMS NPI Registry
Birdena Denise Aguilera, RN
Nurse Practitioner, Family in Lawton, OK. National Provider Identifier 1063904662, active.
NPI record
| NPI | 1063904662 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507 |
| Practice phone | 580-354-5000 |
| Mailing address | 612 N 6th St, Marlow, OK 73055 |
| Enumerated | May 31, 2018 |
| Last updated | January 4, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Emergency | 163WE0003X | 102602 (OK) |
| Nurse Practitioner, Family primary | 363LF0000X | 200329 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.