Provider Demographics
NPI:1194746545
Name:CLARK, APRIL MARIE (CNP)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:MARIE
Last Name:CLARK
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MRS
Other - First Name:APRIL
Other - Middle Name:MARIE
Other - Last Name:BARSTOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:1 CVS DR
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-6146
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:
Practice Address - Street 1:11747 W KEN CARYL AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3700
Practice Address - Country:US
Practice Address - Phone:720-981-2069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN0991205NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2193915Medicaid
OHS57908Medicare UPIN