Provider Demographics
NPI:1790054864
Name:CARR, APRIL LYNN (PA)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:LYNN
Last Name:CARR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:LYNN
Other - Last Name:JENNINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:303 NW LASALLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712
Mailing Address - Country:US
Mailing Address - Phone:816-456-3690
Mailing Address - Fax:913-469-1939
Practice Address - Street 1:2103 SLACK STREET
Practice Address - Street 2:
Practice Address - City:PEA RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72751
Practice Address - Country:US
Practice Address - Phone:479-765-1980
Practice Address - Fax:479-765-1982
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011038211363A00000X
ARPT2025-020363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant