Provider Demographics
NPI:1790303105
Name:ALDRIDGE, NEFERTITI AISHAH (LPN)
Entity Type:Individual
Prefix:MS
First Name:NEFERTITI
Middle Name:AISHAH
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:NEFERTITI
Other - Middle Name:AISHAH
Other - Last Name:NOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:2640 VERA AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-4542
Mailing Address - Country:US
Mailing Address - Phone:513-805-1241
Mailing Address - Fax:
Practice Address - Street 1:2640 VERA AVE APT 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-4542
Practice Address - Country:US
Practice Address - Phone:151-380-5124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-12
Last Update Date:2020-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.167.153.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse