Provider Demographics
NPI:1164204996
Name:CROUCHER, APRIL STAR (CPM)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:STAR
Last Name:CROUCHER
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 E PASS RD STE D
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-3403
Mailing Address - Country:US
Mailing Address - Phone:228-229-8818
Mailing Address - Fax:228-351-0068
Practice Address - Street 1:1204 E PASS RD STE D
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-3403
Practice Address - Country:US
Practice Address - Phone:228-229-8818
Practice Address - Fax:228-351-0068
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA339119176B00000X
367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife