Provider Demographics
NPI:1447850847
Name:HURST, APRIL M
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:M
Last Name:HURST
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:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:PRESTON
Mailing Address - State:OK
Mailing Address - Zip Code:74456-0068
Mailing Address - Country:US
Mailing Address - Phone:918-938-0963
Mailing Address - Fax:918-756-8829
Practice Address - Street 1:1800 S WOOD DR
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-6826
Practice Address - Country:US
Practice Address - Phone:918-756-9646
Practice Address - Fax:918-756-8829
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12938183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist