Provider Demographics
NPI:1265820641
Name:WILSON, APRIL
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 E BRUNO RD
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74525-5306
Mailing Address - Country:US
Mailing Address - Phone:580-364-4235
Mailing Address - Fax:580-889-3088
Practice Address - Street 1:640 E BRUNO RD
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-5306
Practice Address - Country:US
Practice Address - Phone:580-364-4235
Practice Address - Fax:580-889-3088
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator