Provider Demographics
NPI:1679065098
Name:GITTHENS, AARON DEWAYNE (APRN)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:DEWAYNE
Last Name:GITTHENS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 SW STATE ROUTE O
Mailing Address - Street 2:
Mailing Address - City:OSBORN
Mailing Address - State:MO
Mailing Address - Zip Code:64474-9762
Mailing Address - Country:US
Mailing Address - Phone:361-692-8053
Mailing Address - Fax:
Practice Address - Street 1:898 SW STATE ROUTE O
Practice Address - Street 2:
Practice Address - City:OSBORN
Practice Address - State:MO
Practice Address - Zip Code:64474-9762
Practice Address - Country:US
Practice Address - Phone:361-692-8053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018017921363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care