Provider Demographics
NPI:1922439017
Name:AIKEN, KONIKI (NP)
Entity Type:Individual
Prefix:
First Name:KONIKI
Middle Name:
Last Name:AIKEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SKYLAND DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23663-1224
Mailing Address - Country:US
Mailing Address - Phone:252-772-3099
Mailing Address - Fax:
Practice Address - Street 1:860 GREENBRIER CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2640
Practice Address - Country:US
Practice Address - Phone:757-547-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-27
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001172804163W00000X
VA0024170742363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse