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General NPI Number Information
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NPI Number | 1366320442
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Entity Type | Individual
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Provider Name | EDWARD NILES VAN AUKEN
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Gender | Male
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 205 CHARLES T WELLINGTON BUILDING
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City | LEXINGTON
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State | KY
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Zip | 40536-0001
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Country | US
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Telephone | 859-257-5001
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Fax |
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Provider Business Mailing Address
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Address Line | 2490 POLIN RD
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City | WILLISBURG
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State | KY
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Zip | 40078-8032
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Country | US
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Telephone | 518-368-8364
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Fax | 518-368-8364
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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