Provider Demographics
NPI:1538822325
Name:KEA, APRIL MICHELLE
Entity type:Individual
Prefix:DR
First Name:APRIL
Middle Name:MICHELLE
Last Name:KEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 HAWHAMMOCK CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-3914
Mailing Address - Country:US
Mailing Address - Phone:478-299-0960
Mailing Address - Fax:
Practice Address - Street 1:1144 HAWHAMMOCK CHURCH RD
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-3914
Practice Address - Country:US
Practice Address - Phone:478-299-0960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00171M00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator