Provider Demographics
NPI:1669144846
Name:CLARK, APRIL DAWN (NP)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:DAWN
Last Name:CLARK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:DAWN
Other - Last Name:BOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 932909
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0026
Mailing Address - Country:US
Mailing Address - Phone:330-854-4281
Mailing Address - Fax:330-854-0829
Practice Address - Street 1:860 BROAD ST
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-9052
Practice Address - Country:US
Practice Address - Phone:330-331-7106
Practice Address - Fax:330-331-7556
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0029716363LF0000X, 363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology