Healthcare Provider Details

I. General information

NPI: 1851216154
Provider Name (Legal Business Name): AIDAN CONWAY BSN, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 MCFARLAND BLVD STE C
NORTHPORT AL
35476-3333
US

IV. Provider business mailing address

411 WALNUT ST # 23894
GREEN COVE SPRINGS FL
32043-3443
US

V. Phone/Fax

Practice location:
  • Phone: 205-409-9601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number1-195204
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number1-195204
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: