Provider Demographics
NPI:1598399636
Name:BYRD, APRIL SHANELLE
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:SHANELLE
Last Name:BYRD
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 1:1192 FAWN FOREST RD
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-0019
Mailing Address - Country:US
Mailing Address - Phone:870-995-2633
Mailing Address - Fax:
Practice Address - Street 1:1192 FAWN FOREST RD
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-0019
Practice Address - Country:US
Practice Address - Phone:870-995-2633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator