Healthcare Provider Details

I. General information

NPI: 1144460221
Provider Name (Legal Business Name): APRIL M CADREAU CSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2009
Last Update Date: 06/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5235 E SOUTHERN AVE STE D106-159
MESA AZ
85206
US

IV. Provider business mailing address

5235 E SOUTHERN AVE STE D106-159
MESA AZ
85206-3626
US

V. Phone/Fax

Practice location:
  • Phone: 480-600-4901
  • Fax: 480-203-2291
Mailing address:
  • Phone: 480-600-4901
  • Fax: 480-203-2291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: