Healthcare Provider Details

I. General information

NPI: 1316774052
Provider Name (Legal Business Name): APRIL BEAVERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 09/17/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 HWY 467 N
TRUMANN AR
72472
US

IV. Provider business mailing address

831 HWY 467 N
TRUMANN AR
72472
US

V. Phone/Fax

Practice location:
  • Phone: 870-418-0794
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: