Healthcare Provider Details

I. General information

NPI: 1174268551
Provider Name (Legal Business Name): APRIL NICOLE ALLEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2022
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6151 N MAIN STREET RD
WEBB CITY MO
64870-8189
US

IV. Provider business mailing address

6151 N MAIN STREET RD
WEBB CITY MO
64870-8189
US

V. Phone/Fax

Practice location:
  • Phone: 417-556-5350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number31253
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2022016284
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: