Provider Demographics
NPI:1770849911
Name:QUALLEY, APRIL ALISA (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:ALISA
Last Name:QUALLEY
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 UNIVERSITY DR S
Mailing Address - Street 2:PLASTIC SURGERY
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6029
Mailing Address - Country:US
Mailing Address - Phone:701-234-8900
Mailing Address - Fax:701-234-8475
Practice Address - Street 1:2801 UNIVERSITY DR S
Practice Address - Street 2:PLASTIC SURGERY
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6029
Practice Address - Country:US
Practice Address - Phone:701-234-8900
Practice Address - Fax:701-234-8475
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 137321-5363LA2200X
NDR36842363LA2200X, 163WW0000X, 163WX1500X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care