Provider Demographics
NPI:1295340636
Name:CHISM-LYTLE, APRIL C (LPN)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:C
Last Name:CHISM-LYTLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7328 N 85TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-1488
Mailing Address - Country:US
Mailing Address - Phone:402-212-8087
Mailing Address - Fax:
Practice Address - Street 1:7328 N 85TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-1488
Practice Address - Country:US
Practice Address - Phone:402-212-8087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-12
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22944164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE9906120Medicaid