Provider Demographics
NPI:1225023336
Name:ENOS, AIMEE S (CRNP)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:S
Last Name:ENOS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 S KIMBERLY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2022
Mailing Address - Country:US
Mailing Address - Phone:814-445-3535
Mailing Address - Fax:814-445-3245
Practice Address - Street 1:229 S KIMBERLY AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2022
Practice Address - Country:US
Practice Address - Phone:814-445-3535
Practice Address - Fax:814-445-3245
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP002090B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA951901G1NMedicare ID - Type Unspecified
PAS46124Medicare UPIN