Provider Demographics
NPI:1306405733
Name:AMES, APRIL ELLEN
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:ELLEN
Last Name:AMES
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 1:11775 N ISABELLA RD
Mailing Address - Street 2:
Mailing Address - City:CLARE
Mailing Address - State:MI
Mailing Address - Zip Code:48617-9186
Mailing Address - Country:US
Mailing Address - Phone:989-386-8113
Mailing Address - Fax:
Practice Address - Street 1:11775 N ISABELLA RD
Practice Address - Street 2:
Practice Address - City:CLARE
Practice Address - State:MI
Practice Address - Zip Code:48617-9186
Practice Address - Country:US
Practice Address - Phone:989-386-8113
Practice Address - Fax:989-386-8139
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered