Provider Demographics
NPI:1417689365
Name:AIKEN, CRYSTAL E (LPN)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:E
Last Name:AIKEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3936 NEW RD
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-4626
Mailing Address - Country:US
Mailing Address - Phone:330-716-5305
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:3936 NEW RD
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-4626
Practice Address - Country:US
Practice Address - Phone:330-716-5305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.180361.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse