Provider Demographics
NPI:1144342098
Name:CLARK, APRIL NICOLE (PT)
Entity type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:NICOLE
Last Name:CLARK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:APRIL
Other - Middle Name:NICOLE
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1695 VALPARAISO BLVD
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-2950
Mailing Address - Country:US
Mailing Address - Phone:423-503-8000
Mailing Address - Fax:
Practice Address - Street 1:996 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2824
Practice Address - Country:US
Practice Address - Phone:850-863-7651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7052PT225100000X
FLPT41861225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist