Provider Demographics
NPI:1114353703
Name:VICK, AARON C (APN FNP-BC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:C
Last Name:VICK
Suffix:
Gender:M
Credentials:APN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018-2636
Mailing Address - Country:US
Mailing Address - Phone:859-609-9714
Mailing Address - Fax:
Practice Address - Street 1:27 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-2636
Practice Address - Country:US
Practice Address - Phone:859-609-9714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID57696363LF0000X
OHCOA.18959-NP363LF0000X, 363LF0000X
MTNUR-APRN-LIC-127977363LF0000X
KY3010152363LF0000X
MECNP161153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1147725OtherKENTUCKY RN
ID57696OtherAPRN LICENSURE
NJAPN 26NJ00464900OtherNEW JERSEY
OHRN.325335-1OtherOHIO RN
MECNP161153OtherMAINE LICENSURE
KY3010152OtherKENTUCKY APRN
MTAPRN-LIC-127977OtherAPRN
OHCOA.18959-NPOtherOHIO NURSE PRACTITIONER LICENSE