Healthcare Provider Details

I. General information

NPI: 1225891765
Provider Name (Legal Business Name): APRIL KRISTINA WALTERS APRN, ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2124 14TH ST
MERIDIAN MS
39301-4040
US

IV. Provider business mailing address

10850 BAYLOR RD
MERIDIAN MS
39305-9599
US

V. Phone/Fax

Practice location:
  • Phone: 601-553-6000
  • Fax:
Mailing address:
  • Phone: 601-616-1473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number906489
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: