Provider Demographics
NPI:1396184065
Name:PICKENS, AUBRIE LYNN
Entity Type:Individual
Prefix:
First Name:AUBRIE
Middle Name:LYNN
Last Name:PICKENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 WESTLAND RD
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3322
Mailing Address - Country:US
Mailing Address - Phone:307-637-8869
Mailing Address - Fax:307-638-0467
Practice Address - Street 1:1780 WESTLAND RD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3322
Practice Address - Country:US
Practice Address - Phone:307-637-8869
Practice Address - Fax:307-638-0467
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator