Healthcare Provider Details

I. General information

NPI: 1720413461
Provider Name (Legal Business Name): APRIL WILSON-WARREN NP-C PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2013
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MAIN ST S STE 301
MINOT ND
58701-3956
US

IV. Provider business mailing address

315 MAIN ST S STE 301
MINOT ND
58701-3956
US

V. Phone/Fax

Practice location:
  • Phone: 701-838-1558
  • Fax:
Mailing address:
  • Phone: 701-838-1558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberR30556
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberR30556
License Number StateND

VIII. Authorized Official

Name: APRIL ELIZABETH WARREN
Title or Position: NURSE PRACTITIONER
Credential: NP-C
Phone: 701-838-1558