Donald Edward Casebolt, NURSE PRACTITIONER
Individual provider Active NPI Family Nurse Practitioner · Nipomo, CA
NPI 1053343046 · NPPES record last updated Jul 2, 2013
Key facts
- NPI
- 1053343046
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 585025 (CA)
- Practice address
- 150 Tejas PL
Nipomo, CA 93444-9123 - Phone
- (805) 929-3211
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 585025 | CA | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 585025 | CA | |
| Diabetes Educator Registered Nurse | 163WD0400X | 585025 | CA | |
| Ambulatory Care Registered Nurse | 163WP2201X | 585025 | CA | |
| Family Nurse Practitioner | 363LF0000X | 585025 | CA | Yes |
Addresses
Primary practice location
150 Tejas PL
Nipomo, CA 93444-9123
Mailing address
1416 Calle Margarita
Santa Maria, CA 93458-8320
Phone (805) 266-5331
Other providers in Nipomo, CA
- Kari Marie Bowron
- Elisabeth C Box
- Joni Kaye Brewer
- Kerren D Brown
- Brooks Burnsed
- Riley Cash
- Stewart Cassell
- Elizabeth Castillejo
- Franco Jason Castrejon
- Cecelia Catena
All providers in Nipomo, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.