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General NPI Number Information
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NPI Number | 1275104911
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Entity Type | Individual
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Provider Name | KELSEY RENAE AIKENS APRN
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Gender | Female
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Dates
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Enumeration Date | 07/04/2021
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Last Update Date | 07/04/2021
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Provider Practice Location Address
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Address Line | 762 S CLEVELAND MASSILLON RD
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City | FAIRLAWN
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State | OH
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Zip | 44333-3024
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Country | US
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Telephone | 330-388-2758
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Fax |
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Provider Business Mailing Address
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Address Line | 1985 SEDRO ST
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City | CUYAHOGA FALLS
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State | OH
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Zip | 44221-4360
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Country | US
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Telephone | 330-388-2758
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0029180
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License Number State | OH
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