Provider Demographics
NPI:1720702772
Name:THURSTON, APRIL BOCKIN (PA)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:BOCKIN
Last Name:THURSTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:LEIGH
Other - Last Name:BOCKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:14966 BOULDER POINTE RD
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-2407
Mailing Address - Country:US
Mailing Address - Phone:952-687-1416
Mailing Address - Fax:
Practice Address - Street 1:14966 BOULDER POINTE RD
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-2407
Practice Address - Country:US
Practice Address - Phone:952-687-1416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN14534363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant