Provider Demographics
NPI:1952797979
Name:STACEY, APRIL (QBHP)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:STACEY
Suffix:
Gender:F
Credentials:QBHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 176
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:72525
Mailing Address - Country:US
Mailing Address - Phone:870-856-3337
Mailing Address - Fax:870-856-3334
Practice Address - Street 1:2012 HIGHWAY 62/412
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:AR
Practice Address - Zip Code:72542
Practice Address - Country:US
Practice Address - Phone:870-856-3337
Practice Address - Fax:870-856-3334
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist