Provider Demographics
NPI:1689013864
Name:AIMERS, ALLYSON (RN-BSN)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:AIMERS
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2253 COLLEGE WAY
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-5530
Mailing Address - Country:US
Mailing Address - Phone:816-456-1253
Mailing Address - Fax:
Practice Address - Street 1:2253 COLLEGE WAY
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-5530
Practice Address - Country:US
Practice Address - Phone:816-456-1253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2024-12-06
Deactivation Date:2024-11-01
Deactivation Code:
Reactivation Date:2024-11-14
Provider Licenses
StateLicense IDTaxonomies
OR201701846RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse