Basic Information
| Provider Information | |||||||||
| NPI: | 1245724012 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILSON | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | LATRICE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1757 INDIAN WOOD CIR | ||||||||
| Address2: | |||||||||
| City: | MAUMEE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435374009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662030308 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4104 BERWICK AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436121516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5673155025 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2018 | ||||||||
| LastUpdateDate: | 06/15/2018 | ||||||||
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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 | 164W00000X | LPN.156299.MEDS-IV | OH | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.