Nathaniel Paul Kowolik I

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

714276 Issued in CA

Practice address

2044 Nelson Rd
McKinleyville, CA 95519-4241

Phone

(530) 215-6563

NPI assigned

Apr 29, 2025

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

State licenses

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

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1194513002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2044 NELSON RD",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955194241",
            "telephone_number": "530-215-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2044 NELSON RD",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955194241",
            "telephone_number": "530-215-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWOLIK",
        "first_name": "NATHANIEL",
        "middle_name": "PAUL",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "714276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee Louise Keiser, OT
• Patricia Kay Kerig, PHD
• Kimberly Lynne Kerpan, COTA
• Kelly A Kinsley, M.D.
• Kathy Koeppen, LMFT
• Blair Kreuzer
• Mason Labash, PHARMD
• Kelsey Fay Landis, RN
• Tracy Lynne Langhurst, PA-C
• Luis Horacio Lara

• Licensed Vocational Nurse in McKinleyville, CA
• Providers in McKinleyville, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.