Provider Demographics
NPI:1487537031
Name:AGUAK, ACAI
Entity type:Individual
Prefix:
First Name:ACAI
Middle Name:
Last Name:AGUAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5002 AMBER VALLEY PKWY S APT 309
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8704
Mailing Address - Country:US
Mailing Address - Phone:701-612-1837
Mailing Address - Fax:
Practice Address - Street 1:5002 AMBER VALLEY PKWY S APT 309
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8704
Practice Address - Country:US
Practice Address - Phone:701-612-1837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND46222373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist