Provider Demographics
NPI:1104111087
Name:WISE, APRIL R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:APRIL
Middle Name:R
Last Name:WISE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:APRIL
Other - Middle Name:R
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:75 SHOEMAKER CT APT 305
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-8787
Mailing Address - Country:US
Mailing Address - Phone:901-922-5728
Mailing Address - Fax:901-213-2362
Practice Address - Street 1:1212 E SHELBY DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-7124
Practice Address - Country:US
Practice Address - Phone:901-346-3336
Practice Address - Fax:901-346-6613
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33177183500000X, 1835P0018X
MSE-010457183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty
No183500000XPharmacy Service ProvidersPharmacist