Edna Aguila De la Cruz, MSN, PMHNP-BC, FNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APN.0999323-NP Issued in CO

Practice address

1600 W 24TH St
Pueblo, CO 81003-1411

Phone

(719) 546-4000

NPI assigned

Dec 30, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1546128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1780156885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W 24TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810031411",
            "telephone_number": "719-546-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 24TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810031411",
            "telephone_number": "719-546-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "EDNA",
        "middle_name": "AGUILA",
        "credential": "MSN, PMHNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-30",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0999323-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0999323-NP",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CO",
            "license": "RN.1651711",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.