Healthcare Provider Details

I. General information

NPI: 1558157883
Provider Name (Legal Business Name): AARON ADEN FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2588 N WESTWOOD BLVD
POPLAR BLUFF MO
63901-2339
US

IV. Provider business mailing address

3100 OAK GROVE RD
POPLAR BLUFF MO
63901-1573
US

V. Phone/Fax

Practice location:
  • Phone: 573-778-1277
  • Fax:
Mailing address:
  • Phone: 573-776-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2025012518
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: