Provider Demographics
NPI:1720413461
Name:APRIL WILSON-WARREN NP-C PLLC
Entity Type:Organization
Organization Name:APRIL WILSON-WARREN NP-C PLLC
Other - Org Name:SERENITY HEALTH SOLUTIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:701-838-1558
Mailing Address - Street 1:315 MAIN ST S STE 301
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-3956
Mailing Address - Country:US
Mailing Address - Phone:701-838-1558
Mailing Address - Fax:
Practice Address - Street 1:315 MAIN ST S STE 301
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3956
Practice Address - Country:US
Practice Address - Phone:701-838-1558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR30556261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND19982Medicaid
714665Medicare PIN