Healthcare Provider Details

I. General information

NPI: 1801857792
Provider Name (Legal Business Name): SARAH EVELYN AITKEN F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 WESTWOOD ST
ASHLAND OR
97520-1664
US

IV. Provider business mailing address

130 WESTWOOD ST
ASHLAND OR
97520-1664
US

V. Phone/Fax

Practice location:
  • Phone: 541-868-4287
  • Fax: 732-605-5952
Mailing address:
  • Phone: 541-868-4287
  • Fax: 732-605-5952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number092006862
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number092006862N1
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: