Provider Demographics
NPI:1033499215
Name:BOITANO, APRIL MICHELLE (CNM, WHNP)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:MICHELLE
Last Name:BOITANO
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MISSION BLVD
Mailing Address - Street 2:SUITE 2800
Mailing Address - City:JACKSON
Mailing Address - State:CA
Mailing Address - Zip Code:95642-2536
Mailing Address - Country:US
Mailing Address - Phone:209-257-0177
Mailing Address - Fax:
Practice Address - Street 1:100 MISSION BLVD
Practice Address - Street 2:SUITE 2800
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-2536
Practice Address - Country:US
Practice Address - Phone:209-257-0177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1951367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1033499215Medicaid