Provider Demographics
NPI:1073749248
Name:NELSON, APRILLE RASHEDA (DMD)
Entity Type:Individual
Prefix:DR
First Name:APRILLE
Middle Name:RASHEDA
Last Name:NELSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-1761
Mailing Address - Country:US
Mailing Address - Phone:859-253-3242
Mailing Address - Fax:859-253-0025
Practice Address - Street 1:556 N BROADWAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1761
Practice Address - Country:US
Practice Address - Phone:859-253-3242
Practice Address - Fax:859-253-0025
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY87311223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist