Provider Demographics
NPI:1982306619
Name:AIKENS, BRIAN A
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:A
Last Name:AIKENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 BRIDGEPORT TRL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1464
Mailing Address - Country:US
Mailing Address - Phone:216-407-1226
Mailing Address - Fax:
Practice Address - Street 1:310 BRIDGEPORT TRL
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1464
Practice Address - Country:US
Practice Address - Phone:216-407-1226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH314548163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse