Individual provider Active NPI

Lyn Aquino

  • Licensed Practical Nurse
  • Missoula, MT
National Provider Identifier
1558056549
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
176325 Issued in CA
Practice address
1715 S Reserve St Ste B
Missoula, MT 59801-4708
Phone
(406) 304-3015
Fax
(406) 304-3096
NPI assigned
Apr 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 176325 CA Primary

Addresses

Primary practice location

1715 S Reserve St Ste B
Missoula, MT 59801-4708

Mailing address

1715 S Reserve St Ste B
Missoula, MT 59801-4708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
176325CAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Luxe Home Care CurrentSince Apr 9, 2023 Accepting new patients

Locations

1715 S Reserve St
Ste B
Missoula, MT 59801
Phone (406) 304-3015

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1558056549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 S RESERVE ST STE B",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 S RESERVE ST STE B",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014708",
            "telephone_number": "406-304-3015",
            "fax_number": "406-304-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AQUINO",
        "first_name": "LYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CA",
            "license": "176325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.