Provider Demographics
NPI:1124585112
Name:AIKEN, WINSOME M
Entity type:Individual
Prefix:MRS
First Name:WINSOME
Middle Name:M
Last Name:AIKEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 S AMELIA AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-6905
Mailing Address - Country:US
Mailing Address - Phone:386-279-8603
Mailing Address - Fax:
Practice Address - Street 1:999 S AMELIA AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-6905
Practice Address - Country:US
Practice Address - Phone:386-279-8603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide