Provider Demographics
NPI:1518652619
Name:BAZZINI, APRIL (IDMT)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:BAZZINI
Suffix:
Gender:F
Credentials:IDMT
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:
Other - Last Name:WELCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1036 HARDMAN RD
Mailing Address - Street 2:
Mailing Address - City:ELLAMORE
Mailing Address - State:WV
Mailing Address - Zip Code:26267-5649
Mailing Address - Country:US
Mailing Address - Phone:304-904-1277
Mailing Address - Fax:
Practice Address - Street 1:1599 JONES STEET
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58205
Practice Address - Country:US
Practice Address - Phone:701-747-5504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
Provider Identifiers
StateIdentifier IDID TypeIssuer
1609327428OtherUSAF ORGANIZATION