Provider Demographics
NPI:1689697799
Name:PEARSON, AIMEE L (FNP)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:L
Last Name:PEARSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 601884
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1884
Mailing Address - Country:US
Mailing Address - Phone:980-487-1148
Mailing Address - Fax:704-487-7753
Practice Address - Street 1:1124 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3862
Practice Address - Country:US
Practice Address - Phone:980-487-1148
Practice Address - Fax:704-487-7753
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201117363LF0000X
NC155755363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00406775OtherRR MEDICARE
NC1689697799Medicaid
NC7004039Medicaid
SCNP1385Medicaid
SCNP1385Medicaid
NCNCE357AMedicare PIN
NC1689697799Medicaid
NC2591252AMedicare PIN