Provider Demographics
NPI:1205825429
Name:PARKS, APRIL SUSAN (FNP)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:SUSAN
Last Name:PARKS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9240 N MERIDIAN ST STE 160
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1827
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9240 N MERIDIAN ST STE 160
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1827
Practice Address - Country:US
Practice Address - Phone:317-415-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704303374363LF0000X
IN71001557363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000284090OtherATHEM
IN00000634021OtherANTHEM
IN000000642286OtherANTHEM
MI080F360200OtherBCBSM GROUP
IN200438610Medicaid
IN00000634021OtherANTHEM
IN259060CCMedicare PIN
IN200438610Medicaid
IN070860E9Medicare PIN
IN000000642286OtherANTHEM
IN069860ZZZZMedicare PIN