Provider Demographics
NPI:1891723029
Name:NALLE, APRIL LYNN
Entity Type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:LYNN
Last Name:NALLE
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 1:310 LANGDON ST
Mailing Address - Street 2:STE., 3
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2795
Mailing Address - Country:US
Mailing Address - Phone:606-678-0033
Mailing Address - Fax:606-678-0056
Practice Address - Street 1:310 LANGDON ST
Practice Address - Street 2:STE., 3
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2795
Practice Address - Country:US
Practice Address - Phone:606-678-0033
Practice Address - Fax:606-678-0056
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90011792Medicaid
KY000000374383OtherANTHEM PROVIDER #
KY90011792Medicaid