Healthcare Provider Details

I. General information

NPI: 1588957682
Provider Name (Legal Business Name): APRIL D MCMANES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: APRIL VANDENBURG PA-C

II. Dates (important events)

Enumeration Date: 05/23/2011
Last Update Date: 04/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CHERRY ST SE
GRAND RAPIDS MI
49503
US

IV. Provider business mailing address

1400 44TH ST SE
KENTWOOD MI
49508
US

V. Phone/Fax

Practice location:
  • Phone: 616-685-5600
  • Fax: 685-685-6745
Mailing address:
  • Phone: 616-685-8500
  • Fax: 231-727-4451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601006027
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: