Provider Demographics
NPI:1033919253
Name:AGUILAR DE LEON, MONIQUE MICHELLE (LPN)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:MICHELLE
Last Name:AGUILAR DE LEON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 GREENBANK ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-1414
Mailing Address - Country:US
Mailing Address - Phone:503-484-4997
Mailing Address - Fax:
Practice Address - Street 1:1104 GREENBANK ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-1414
Practice Address - Country:US
Practice Address - Phone:503-484-4997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV878635164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse