Provider Demographics
NPI:1326635053
Name:DICKE, APRIL RENEE
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:RENEE
Last Name:DICKE
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 1:10318 NEPTUNE MENDON RD
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:OH
Mailing Address - Zip Code:45862-9755
Mailing Address - Country:US
Mailing Address - Phone:419-733-9826
Mailing Address - Fax:
Practice Address - Street 1:10318 NEPTUNE MENDON RD
Practice Address - Street 2:
Practice Address - City:MENDON
Practice Address - State:OH
Practice Address - Zip Code:45862-9755
Practice Address - Country:US
Practice Address - Phone:419-733-9826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5401631Medicaid