CASEY GERALD DESHAMBO NPI 1386138568

NPI Information

Casey Gerald Deshambo is a student in an organized health care education training program in Green Bay, WI with 9 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Casey Gerald Deshambo NPI is 1386138568. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2100 MEMORIAL DR APT 207
GREEN BAY, WI
ZIP 54303-309
Phone: (906) 399-6491

The NPI 1386138568 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/20/2018 and was last updated on 6/20/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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