Provider Demographics
NPI:1053968776
Name:COUCH, APRIL MICHELLE (APRN)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:MICHELLE
Last Name:COUCH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:MICHELLE
Other - Last Name:ROARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:509 MEMORIAL DR STE 2
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-6196
Mailing Address - Country:US
Mailing Address - Phone:606-598-5104
Mailing Address - Fax:606-598-0983
Practice Address - Street 1:65 GLENNDALE RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-6212
Practice Address - Country:US
Practice Address - Phone:606-598-4529
Practice Address - Fax:606-599-2529
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1129359163W00000X
KY3013822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse