Provider Demographics
NPI:1528289105
Name:MALLOY, APRIL MARIE (A-GNP-C)
Entity type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:MARIE
Last Name:MALLOY
Suffix:
Gender:F
Credentials:A-GNP-C
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:
Other - Last Name:STAUFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3010 YORKSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2428
Mailing Address - Country:US
Mailing Address - Phone:440-339-5855
Mailing Address - Fax:
Practice Address - Street 1:2570 SOM CENTER RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-9607
Practice Address - Country:US
Practice Address - Phone:440-943-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH323183163W00000X
OHAPRN.CNP.0031755207R00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine