Provider Demographics
NPI:1447245956
Name:EBERSOLE, APRIL DAWN (ANP)
Entity Type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:DAWN
Last Name:EBERSOLE
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 E BROAD ST STE E
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3390
Mailing Address - Country:US
Mailing Address - Phone:931-510-9231
Mailing Address - Fax:207-810-5946
Practice Address - Street 1:441 E BROAD ST STE E
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3390
Practice Address - Country:US
Practice Address - Phone:931-510-9231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN72716531363LA2200X
TNRN109928363LA2200X
TNAPN7381363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1520468Medicaid
TN1520468Medicaid