Provider Demographics
NPI:1366320442
Name:VAN AUKEN, EDWARD NILES
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:NILES
Last Name:VAN AUKEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 POLIN RD
Mailing Address - Street 2:
Mailing Address - City:WILLISBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40078-8032
Mailing Address - Country:US
Mailing Address - Phone:518-368-8364
Mailing Address - Fax:518-368-8364
Practice Address - Street 1:205 CHARLES T WELLINGTON BUILDING
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-257-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program