Healthcare Provider Details

I. General information

NPI: 1194099531
Provider Name (Legal Business Name): APRIL DAWN WILLARD RN, MSN, NNP, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2012
Last Update Date: 04/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 N BROAD ST
PHILADELPHIA PA
19140-5103
US

IV. Provider business mailing address

2450 W HUNTING PARK AVE
PHILADELPHIA PA
19129-1302
US

V. Phone/Fax

Practice location:
  • Phone: 215-707-6606
  • Fax: 215-707-6428
Mailing address:
  • Phone: 215-707-6606
  • Fax: 215-707-6428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberSP013779
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: