Provider Demographics
NPI:1205198231
Name:EIDSON, AIMEE NICOLE (DO)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:NICOLE
Last Name:EIDSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:NICOLE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5701 W 119TH ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3721
Mailing Address - Country:US
Mailing Address - Phone:913-498-8787
Mailing Address - Fax:913-498-1744
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3721
Practice Address - Country:US
Practice Address - Phone:913-498-8787
Practice Address - Fax:913-498-1744
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-38099208M00000X
MO2015021663208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist