Healthcare Provider Details

I. General information

NPI: 1710498712
Provider Name (Legal Business Name): CHRISTINA AGUILLON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 MARLANDWOOD RD STE 118
TEMPLE TX
76502-3341
US

IV. Provider business mailing address

1005 MARLANDWOOD RD STE 118
TEMPLE TX
76502-3341
US

V. Phone/Fax

Practice location:
  • Phone: 254-410-7226
  • Fax: 254-410-7241
Mailing address:
  • Phone: 254-410-7226
  • Fax: 254-410-7241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number751116
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: