Provider Demographics
NPI:1639147937
Name:NABAHE, APRIL RACQUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:APRIL
Middle Name:RACQUEL
Last Name:NABAHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:SHIPROCK
Mailing Address - State:NM
Mailing Address - Zip Code:87420-0160
Mailing Address - Country:US
Mailing Address - Phone:505-368-6627
Mailing Address - Fax:505-368-6688
Practice Address - Street 1:US HWY 491 NORTH
Practice Address - Street 2:
Practice Address - City:SHIPROCK
Practice Address - State:NM
Practice Address - Zip Code:87420
Practice Address - Country:US
Practice Address - Phone:505-368-6627
Practice Address - Fax:505-368-6688
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND8884208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ766719Medicaid
NM77572203Medicaid
CO02327244Medicaid
8HG910Medicare PIN
AZ766719Medicaid
NM77572203Medicaid
H80039Medicare UPIN