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Individual

REBECCA AIKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 701-4434
Mailing address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 701-4434

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R153259
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
570040000
MD
01
972037-01
BLUE CROSS/BLUE SHIELD
MD
01
S062-0416
REGIONAL BC/BS
MD
Enumeration date
11/18/2010
Last updated
08/24/2016
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