Provider Demographics
NPI:1194331462
Name:AARON, ATLEY (PNP-PC)
Entity type:Individual
Prefix:
First Name:ATLEY
Middle Name:
Last Name:AARON
Suffix:
Gender:F
Credentials:PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 CEDARWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-1404
Mailing Address - Country:US
Mailing Address - Phone:410-259-4428
Mailing Address - Fax:
Practice Address - Street 1:105 VINEYARD WAY
Practice Address - Street 2:
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-8849
Practice Address - Country:US
Practice Address - Phone:410-259-4428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022343363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics