Basic Information
| Provider Information | |||||||||
| NPI: | 1629381504 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NELSON | ||||||||
| FirstName: | APRIL | ||||||||
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| Credential: | M. ED, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 113 HILLCREST DR | ||||||||
| Address2: | |||||||||
| City: | SANFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273304020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197770240 | ||||||||
| FaxNumber: | 9197770499 | ||||||||
| Practice Location | |||||||||
| Address1: | 113 HILLCREST DR | ||||||||
| Address2: | |||||||||
| City: | SANFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273304020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197770240 | ||||||||
| FaxNumber: | 9197770499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2010 | ||||||||
| LastUpdateDate: | 07/20/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 8973 | NC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.