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General NPI Number Information
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NPI Number | 1699196527
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Entity Type | Individual
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Provider Name | AISHA STEVENSON REIKOW PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/19/2013
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 13215 BROOK LANE
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City | HAGERSTOWN
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State | MD
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Zip | 21742-2174
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Country | US
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Telephone | 301-733-0331
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Fax |
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Provider Business Mailing Address
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Address Line | 484 WILLIAMSPORT PIKE # 285
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City | MARTINSBURG
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State | WV
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Zip | 25404-5707
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Country | US
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Telephone | 610-850-4713
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Fax | 207-881-4771
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024176974
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AC003049
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 87515
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License Number State | WV
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