Basic Information
| Provider Information | |||||||||
| NPI: | 1194058826 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARCHER | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | BELLE | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14 W JORDAN ST | ||||||||
| Address2: | |||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325011736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504364630 | ||||||||
| FaxNumber: | 8504362095 | ||||||||
| Practice Location | |||||||||
| Address1: | 5520 STEWART ST | ||||||||
| Address2: | |||||||||
| City: | MILTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325704304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8509819433 | ||||||||
| FaxNumber: | 8509819436 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2009 | ||||||||
| LastUpdateDate: | 03/09/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | ARNP9205190 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 000893000 | 05 | FL | MEDICAID |