Provider Demographics
NPI:1447012513
Name:AIKEN, JEWELL
Entity type:Individual
Prefix:
First Name:JEWELL
Middle Name:
Last Name:AIKEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEWELL
Other - Middle Name:
Other - Last Name:BURNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2300 W EL SEGUNDO BLVD APT 16
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90249-1664
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2300 W EL SEGUNDO BLVD APT 16
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249-1664
Practice Address - Country:US
Practice Address - Phone:323-314-4346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula