1437521697 NPI number — MRS. APRIL LYNN STOREY-CORNELIUS APRN-CNP/CRNP

Table of content: MRS. APRIL LYNN STOREY-CORNELIUS APRN-CNP/CRNP (NPI 1437521697)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437521697 NPI number — MRS. APRIL LYNN STOREY-CORNELIUS APRN-CNP/CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STOREY-CORNELIUS
Provider First Name:
APRIL
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN-CNP/CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STOREY
Provider Other First Name:
APRIL
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437521697
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3004 HAYES AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANDUSKY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44870-5321
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-626-6161
Provider Business Mailing Address Fax Number:
419-502-3511

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1044 BELMONT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YOUNGSTOWN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44504-1006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-626-6161
Provider Business Practice Location Address Fax Number:
419-502-3511
Provider Enumeration Date:
10/28/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  SP019986 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: APRN.CNP.18343 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0150751 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".