Healthcare Provider Details

I. General information

NPI: 1275980690
Provider Name (Legal Business Name): APRIL M ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2016
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E MAUMEE ST
ANGOLA IN
46703-2012
US

IV. Provider business mailing address

416 E MAUMEE ST
ANGOLA IN
46703-2015
US

V. Phone/Fax

Practice location:
  • Phone: 260-675-7535
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71006577A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: