William Clare Cebulla, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

R 140921-5 Issued in MN

Practice address

29538 Olinda TRL
Lindstrom, MN 55045-9440

Phone

(651) 247-9069

NPI assigned

Jun 27, 2013

Last updated

Jun 27, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1043650534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29538 OLINDA TRL",
            "city": "LINDSTROM",
            "state": "MN",
            "postal_code": "550459440",
            "telephone_number": "651-247-9069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29538 OLINDA TRL",
            "city": "LINDSTROM",
            "state": "MN",
            "postal_code": "550459440",
            "telephone_number": "651-247-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEBULLA",
        "first_name": "WILLIAM",
        "middle_name": "CLARE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MN",
            "license": "R 140921-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Psychiatric/Mental Health Registered Nurse in Lindstrom, MN
• Providers in Lindstrom, MN by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.