Individual
MR. DONALD EDWARD CASEBOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
150 TEJAS PL, NIPOMO, CA 93444-9123
(805) 929-3211
Mailing address
1416 CALLE MARGARITA, SANTA MARIA, CA 93458-8320
(805) 266-5331
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
585025
CA
163WD0400X
Diabetes Educator Registered Nurse
585025
CA
163WP2201X
Ambulatory Care Registered Nurse
585025
CA
363LF0000X
Family Nurse Practitioner
Primary
585025
CA
Other
Enumeration date
07/07/2006
Last updated
07/02/2013
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