Provider Demographics
NPI:1760600522
Name:LAIRSON, AARON D (LPN)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:D
Last Name:LAIRSON
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47371-9401
Mailing Address - Country:US
Mailing Address - Phone:260-726-7366
Mailing Address - Fax:
Practice Address - Street 1:1083 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:OH
Practice Address - Zip Code:45390-8633
Practice Address - Country:US
Practice Address - Phone:937-968-3226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.113067164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse