Basic Information
Provider Information
NPI: 1174762124
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MITCHELL
FirstName: APRIL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BEDFORD
OtherFirstName: APRIL
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 220 RUSKIN DR
Address2:  
City: COLORADO SPRINGS
State: CO
PostalCode: 80910
CountryCode: US
TelephoneNumber: 7195726100
FaxNumber: 7195726080
Practice Location
Address1: 875 WEST MORENO AVE
Address2:  
City: COLORADO SPRINGS
State: CO
PostalCode: 80905
CountryCode: US
TelephoneNumber: 7195726200
FaxNumber: 7195726299
Other Information
ProviderEnumerationDate: 02/16/2009
LastUpdateDate: 11/10/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000X47893COY Nursing Service ProvidersLicensed Practical Nurse 
164W00000XL40583ARN Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


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