Provider Demographics
NPI:1447760822
Name:SCANDALIS-JEFFERSON, APRIL (RN, BSN)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:SCANDALIS-JEFFERSON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21805 ALGER ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1873
Mailing Address - Country:US
Mailing Address - Phone:313-728-2174
Mailing Address - Fax:
Practice Address - Street 1:21805 ALGER ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1873
Practice Address - Country:US
Practice Address - Phone:313-728-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704270007163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse