MRS. AIMEE LYNN EBLEN (NPI# 1518054279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518054279 |
| Entity Type | Individual |
| Full Name | MRS. AIMEE LYNN EBLEN |
| Credential | P.T. |
| Practice Address |
318 W Pike St Suite 104 Lawrenceville GA 30045-3234 |
| Mailing Address |
1810 Millside Ter Dacula GA 30019-3256 |
| Practice Telephone | 7703141388 |
| Practice Fax Number | 6783772882 |
| Mailing Telephone | 7709326612 |
| Mailing Fax Number | 6783772833 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
PT004663 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | AMERIGROUP | 10037612 | 01 |
| GA | PEACHSTATE HEALTH PLAN | 00731882C | 01 |
| GA | 00731882C | 05 | |
| GA | WELLCARE | 307920 | 01 |
| Street Address |
318 W PIKE ST SUITE 104 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30045-3234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922245802 | Leila Evans | Speech-Language Pathologist | 318 W Pike St, Suite 104, Lawrenceville, GA 30045-3234 | 2009-01-14 |
| 1083879282 | Mathilde E Finke | Speech-Language Pathologist | 318 W Pike St, Suite 104, Lawrenceville, GA 30045-3234 | 2008-07-28 |
| 1801066980 | Ellen Razielli Frissell | Speech-Language Pathologist | 318 W Pike St, Suite104, Lawrenceville, GA 30045-3234 | 2008-03-05 |
| 1093904450 | Cheryl Johnson | Speech-Language Pathologist | 318 W Pike St, Suite 104, Lawrenceville, GA 30045-3234 | 2007-10-22 |
| 1336337971 | Denise Hamm | Occupational Therapist | 318 W Pike St, Suite 104, Lawrenceville, GA 30045-3234 | 2007-10-09 |
| 1891987780 | Holli Imig | Speech-Language Pathologist | 318 W Pike St, Suite 104, Lawrenceville, GA 30045-3234 | 2007-08-14 |
| 1952593139 | Lydia Murphey | Speech-Language Pathologist | 318 W Pike St, Suite 104, Lawrenceville, GA 30045-3234 | 2007-08-13 |
| 1700918968 | Christine Browning | Physical Therapist | 318 W Pike St, Suite 104, Lawrenceville, GA 30045-3234 | 2007-03-12 |
| 1518002682 | Kathleen Hill | Speech-Language Pathologist | 318 W Pike St, Suite 104, Lawrenceville, GA 30045-3234 | 2007-02-20 |
| 1164589990 | Darci Debaun | Physical Therapist | 318 W Pike St, Suite 104, Lawrenceville, GA 30045-3234 | 2007-01-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285104315 | Shalanda Monique Booker | Counselor | 2940 Emerald Springs Drive, Lawrenceville, GA 30045 | 2018-12-02 |
| 1669957320 | Chantelle S Fuller | Behavioral Analyst | 805 Donington Cir, Lawrenceville, GA 30045 | 2018-09-28 |
| 1356836035 | Gad Health Care LLC | Home Health | 1140 Great Oaks Dr, Lawrenceville, GA 30045 | 2018-06-26 |
| 1346668662 | Eca Optical, LLC | Eyewear Supplier (Equipment, not the service) | 601-a Professional Drive, Ste 170, Lawrenceville, GA 30045 | 2014-04-03 |
| 1598102733 | Selena Fuller | Nurse Practitioner | 181 South Clayton Street, Lawrenceville, GA 30045 | 2013-05-29 |
| 1942555982 | Vida Michele James-bryant | Community Health Worker | 1309 Avington Glen Dr, Lawrenceville, GA 30045 | 2012-07-16 |
| 1770840639 | Rebecca Vinson D'angelo | Occupational Therapist | 1518 Great Shoals Cir, Lawrenceville, GA 30045 | 2012-04-17 |
| 1427346774 | Amanda Michelel Woods | Psychologist | 285 South Perry Street, Lawrenceville, GA 30045 | 2011-07-20 |
| 1790070563 | M & G Pharmacy Inc | Pharmacy | 100 Hurricane Shoals Rd Suite F, Lawrenceville, GA 30045 | 2011-06-09 |
| 1306146154 | Thanh Dau | Optometrist | 1250 Scenic Highway, Ste 1268, Lawrenceville, GA 30045 | 2010-10-27 |
| Find all providers in zip 30045 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982809174 | Erin Ashley Cruttenden | Physical Therapist | 545 Old Norcross Road, Suite 100, Lawrenceville, GA 30046-3099 | 2007-06-18 |
| 1861550295 | Carin Ashman | Physical Therapist | 318 West Pike St., Suite 104, Lawrenceville, GA 30045 | 2006-12-05 |
| 1972103869 | Sydney Lewis Askew | Physical Therapist | 545 Old Norcross Rd Ste 100, Lawrenceville, GA 30046-3390 | 2020-10-29 |
| 1477108439 | Jessika Puglisi | Physical Therapist | 545 Old Norcross Rd Ste 100, Lawrenceville, GA 30046-3390 | 2019-08-07 |
| 1831643493 | Vivian Albert | Physical Therapist | 545 Old Norcross Rd Ste 100, Lawrenceville, GA 30046-3390 | 2016-08-11 |
| 1720497043 | Katherine Stroer Benkeser | Physical Therapist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2014-08-12 |
| 1275965725 | Catherine Oddi Lachance | Physical Therapist | 1509 Atkinson Rd, Suite 1100, Lawrenceville, GA 30043-7986 | 2013-08-07 |
| 1922444777 | Julianna Ryan | Physical Therapist | 545 Old Norcross Rd Ste 100, Lawrenceville, GA 30046-3390 | 2013-05-20 |
| 1508098120 | Sarah Meyer | Physical Therapist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2009-08-14 |
| 1700017670 | Amber Thomas | Physical Therapist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2009-07-27 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30045 |
Please comment or provide details below to improve the information on MRS. AIMEE LYNN EBLEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.