Individual
EDNA AGUILA DE LA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, PMHNP-BC, FNP-C
Contact information
Practice address
1600 W 24TH ST, PUEBLO, CO 81003-1411
(719) 546-4000
Mailing address
1600 W 24TH ST, PUEBLO, CO 81003-1411
(719) 546-4000
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
RN.1651711
CO
363LF0000X
Family Nurse Practitioner
APN.0999323-NP
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN.0999323-NP
CO
Other
Enumeration date
12/30/2018
Last updated
01/31/2024
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