Provider Demographics
NPI:1891579280
Name:FUENTES, APRIL DAWN (RN)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:DAWN
Last Name:FUENTES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25130 SOUTHFIELD RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-1900
Mailing Address - Country:US
Mailing Address - Phone:248-234-6797
Mailing Address - Fax:248-621-9003
Practice Address - Street 1:25130 SOUTHFIELD RD STE 120
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-1900
Practice Address - Country:US
Practice Address - Phone:248-234-6797
Practice Address - Fax:248-621-9003
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704404628163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice