Provider Demographics
NPI:1578118923
Name:BETHEA, APRIL
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:BETHEA
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 1:102 STERLING RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ARCHDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27263-3170
Mailing Address - Country:US
Mailing Address - Phone:336-847-9193
Mailing Address - Fax:336-885-0784
Practice Address - Street 1:175 NORTHPOINT AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7737
Practice Address - Country:US
Practice Address - Phone:336-885-0783
Practice Address - Fax:336-885-0784
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC29848342Medicaid