Provider Demographics
NPI: | 1619868833 |
---|---|
Name: | DICKS, APRIL MICHELLE |
Entity type: | Individual |
Prefix: | MRS |
First Name: | APRIL |
Middle Name: | MICHELLE |
Last Name: | DICKS |
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: | 1507 OLD ESTILL SPRINGS RD |
Mailing Address - Street 2: | |
Mailing Address - City: | TULLAHOMA |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37388-5504 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 843-855-5439 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1507 OLD ESTILL SPRINGS RD |
Practice Address - Street 2: | |
Practice Address - City: | TULLAHOMA |
Practice Address - State: | TN |
Practice Address - Zip Code: | 37388-5504 |
Practice Address - Country: | US |
Practice Address - Phone: | 843-855-5439 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2025-07-14 |
Last Update Date: | 2025-07-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TN | 288188 | 163WE0003X |
2255A2300X, 390200000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program | |
No | 163WE0003X | Nursing Service Providers | Registered Nurse | Emergency |
No | 2255A2300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |