Healthcare Provider Details

I. General information

NPI: 1760901136
Provider Name (Legal Business Name): APRIL DAWN FROST FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2017
Last Update Date: 01/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 W BROADWAY STE 100
COLUMBIA MO
65203-1136
US

IV. Provider business mailing address

2003 W BROADWAY STE 100
COLUMBIA MO
65203-1136
US

V. Phone/Fax

Practice location:
  • Phone: 573-777-5880
  • Fax:
Mailing address:
  • Phone: 618-910-7059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2017002707
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: