Provider Demographics
NPI:1710718895
Name:AIKENS, OLIVIA (NATCEP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:AIKENS
Suffix:
Gender:F
Credentials:NATCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TUDOR AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2032
Mailing Address - Country:US
Mailing Address - Phone:216-403-8321
Mailing Address - Fax:
Practice Address - Street 1:100 TUDOR AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2032
Practice Address - Country:US
Practice Address - Phone:216-403-8321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH601737130222376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide