Provider Demographics
NPI:1922431055
Name:MARTIN, AIMEE L (LPN)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:L
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 N OXFORD AVE BLDG 2
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-5187
Mailing Address - Country:US
Mailing Address - Phone:715-834-1078
Mailing Address - Fax:715-834-1218
Practice Address - Street 1:2000 N OXFORD AVENUE BLDG 2
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-5187
Practice Address - Country:US
Practice Address - Phone:715-834-1078
Practice Address - Fax:715-834-1218
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI316986-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse