MEDICARE: MRS. APRIL A TOLBERT WHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	07854	TX

General Provider Information

NPI Number	:	1073821500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. APRIL A TOLBERT WHNP

Provider Business Mailing Address
First Line	:	3825 YUCCA AVE
Second Line	:	STE 129
City	:	FT WORTH
State	:	TX
Zip	:	76111-6067
Country	:	US
Telephone Number	:	817-759-2273
Fax Number	:	817-759-2276

Provider Business Practice Location Address
First Line	:	3825 YUCCA AVE
Second Line	:	STE 129
City	:	FT WORTH
State	:	TX
Zip	:	76111-6067
Country	:	US
Telephone Number	:	817-759-2273
Fax Number	:	817-753-2276

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2010
Last Update Date	:	11/10/2011

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