Healthcare Provider Details

I. General information

NPI: 1104495001
Provider Name (Legal Business Name): MICHAELA E. AITKEN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHAELA GORDON RN

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 MAIN ST
MILFORD MA
01757-2511
US

IV. Provider business mailing address

9 INDUSTRIAL RD STE 5
MILFORD MA
01757-3736
US

V. Phone/Fax

Practice location:
  • Phone: 508-731-2560
  • Fax:
Mailing address:
  • Phone: 508-473-1480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2309191
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN2309191
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN2309191
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: