Aileen M Anom, NP
Nurse Practitioner, Family in Tucker, GA. Individual provider (NPI-1).
NPI number1376531723
StatusActive
Last updated in NPPESFeb 9, 2022
Details
- NPI
- 1376531723
- Entity type
- Individual (NPI-1)
- Name
- Ms. Aileen M Anom
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 10, 2005
- Certification date
- Feb 9, 2022
- Last updated
- Feb 9, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | RN113842 | GA | Yes |
Other names
- Aileen M Wideman (Former Name)
Practice location
200 Crescent Center ParkwayKaiser Permanente Crescent Medical Center
Tucker, GA 30084
Phone 770-496-3414
Mailing address
3495 Piedmont Road, NeNine Piedmont Center
Atlanta, GA 30305
Phone 404-504-5678
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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