Healthcare Provider Details

I. General information

NPI: 1568716942
Provider Name (Legal Business Name): APRIL F KIBBLE MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2012
Last Update Date: 05/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2432 E MAIN ST
JACKSON MO
63755-2487
US

IV. Provider business mailing address

1701 LACEY ST
CAPE GIRARDEAU MO
63701-5230
US

V. Phone/Fax

Practice location:
  • Phone: 573-755-2305
  • Fax:
Mailing address:
  • Phone: 573-334-4822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2012029029
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: