Healthcare Provider Details

I. General information

NPI: 1942390224
Provider Name (Legal Business Name): AARON E BURRELL LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAMEDDAC WUERZBURG, UNIT 26610 US ARMY HEALTH CLINIC-WUERZBURG
APO AE
09244
US

IV. Provider business mailing address

USAMEDDAC WUERZBURG, UNIT 26610 ATTN: CREDENTIALS OFFICE
APO AE
09244
US

V. Phone/Fax

Practice location:
  • Phone: 011499318043
  • Fax: 011499318043
Mailing address:
  • Phone: 011499318043
  • Fax: 011499318043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number167377
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: