Healthcare Provider Details

I. General information

NPI: 1275060113
Provider Name (Legal Business Name): APRIL LYNN WHITNEY HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. APRIL LYNN FLEMING

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 S WALNUT ST
STARKE FL
32091-4413
US

IV. Provider business mailing address

17814 SW 95TH AVE
ARCHER FL
32618-3404
US

V. Phone/Fax

Practice location:
  • Phone: 904-964-4327
  • Fax: 904-368-0574
Mailing address:
  • Phone: 352-214-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS5287
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: