Healthcare Provider Details

I. General information

NPI: 1639004716
Provider Name (Legal Business Name): AGNES MARIE ARAGON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 GRANDE BLVD SE UNIT 3-E
RIO RANCHO NM
87124-1799
US

IV. Provider business mailing address

427 DALLAS ST SE APT C
ALBUQUERQUE NM
87108-4395
US

V. Phone/Fax

Practice location:
  • Phone: 505-359-0505
  • Fax:
Mailing address:
  • Phone: 505-203-0476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: