Provider Demographics
NPI:1467580043
Name:MARTINO, APRIL ANNE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:ANNE
Last Name:MARTINO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:APRIL
Other - Middle Name:ANNE
Other - Last Name:SAUNDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:804 SERVICE RD STE A109B
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-364-5260
Mailing Address - Fax:517-364-5251
Practice Address - Street 1:1200 E MICHIGAN AVE STE 520
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1899
Practice Address - Country:US
Practice Address - Phone:517-364-5260
Practice Address - Fax:517-364-5251
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601003887363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1417961137OtherBCBSM - BRONSON
MIP75730Medicare UPIN
MIC97618291 - BRONSONMedicare PIN