Provider Demographics
NPI:1407410491
Name:JARRETT, APRIL RIVER RUSSELL (PA)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:RIVER RUSSELL
Last Name:JARRETT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2541 W NC 10 HWY
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-9712
Mailing Address - Country:US
Mailing Address - Phone:828-461-3696
Mailing Address - Fax:
Practice Address - Street 1:1 TRADE ST
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-1525
Practice Address - Country:US
Practice Address - Phone:828-396-3136
Practice Address - Fax:828-396-3105
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-08932363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant