Provider Demographics
NPI:1801179874
Name:AIKMAN, LORI (ARNP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:AIKMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANNE
Other - Last Name:SHELLENBACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2582 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32926-2637
Mailing Address - Country:US
Mailing Address - Phone:321-334-4861
Mailing Address - Fax:321-204-6983
Practice Address - Street 1:37 N ORANGE AVE STE 500
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2438
Practice Address - Country:US
Practice Address - Phone:321-334-4861
Practice Address - Fax:321-204-6983
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9251763363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0C40OtherFLORIDA BLUE
FL9085719OtherAETNA