Provider Demographics
NPI:1659027639
Name:LOBDELL, APRIL MICHELLE
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:MICHELLE
Last Name:LOBDELL
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 1:706 FULTON ST APT 7
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-4998
Mailing Address - Country:US
Mailing Address - Phone:715-846-0963
Mailing Address - Fax:
Practice Address - Street 1:303 WESTON AVE
Practice Address - Street 2:
Practice Address - City:ROTHSCHILD
Practice Address - State:WI
Practice Address - Zip Code:54474-1649
Practice Address - Country:US
Practice Address - Phone:715-846-0963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIL134-0138-1724-01172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI7158460963Medicaid