Healthcare Provider Details

I. General information

NPI: 1053063008
Provider Name (Legal Business Name): DR. APRIL LEE CHARLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2022
Last Update Date: 09/01/2024
Certification Date: 09/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 6TH AVE SW
RONAN MT
59864-2634
US

IV. Provider business mailing address

33458 TERRACE LAKE RD
RONAN MT
59864-9876
US

V. Phone/Fax

Practice location:
  • Phone: 406-676-4441
  • Fax:
Mailing address:
  • Phone: 406-212-4353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number242249
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: