Provider Demographics
NPI:1053502021
Name:AIKEN, RALPH RICHARD
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:RICHARD
Last Name:AIKEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RALPH
Other - Middle Name:RICHARD
Other - Last Name:AIKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1511 SCALP AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3315
Mailing Address - Country:US
Mailing Address - Phone:814-254-4207
Mailing Address - Fax:814-254-4733
Practice Address - Street 1:1511 SCALP AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904
Practice Address - Country:US
Practice Address - Phone:814-254-4207
Practice Address - Fax:814-254-4733
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008859363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner