Provider Demographics
NPI:1457936866
Name:ENKE, AIMIE EXLEY
Entity Type:Individual
Prefix:MRS
First Name:AIMIE
Middle Name:EXLEY
Last Name:ENKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AIMIE
Other - Middle Name:LYNN
Other - Last Name:EXLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:123 TULIP ST
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-3109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7880 US HWY 98
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-3255
Practice Address - Country:US
Practice Address - Phone:850-278-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014260363L00000X
FL11014260363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11014260OtherBOARD OF NURSING
F06212624OtherAANP- FNP