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General NPI Number Information
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NPI Number | 1699591115
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Entity Type | Individual
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Provider Name | APRIL PAULK CPT, CNA
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Gender | Female
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Dates
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Enumeration Date | 11/30/2024
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Last Update Date | 11/30/2024
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Provider Practice Location Address
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Address Line | 804 COMMERCE BLVD
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City | RIVERDALE
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State | GA
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Zip | 30296-7198
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Country | US
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Telephone | 404-452-2817
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Fax |
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Provider Business Mailing Address
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Address Line | 35 SUMMER LEIGH DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-5895
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Country | US
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Telephone | 404-452-2817
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | CN0000018284
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | 20-1310Y09
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License Number State | GA
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