person
Casey Gerald Deshambo
Student in an Organized Health Care Education/Training Program in Green Bay, Wisconsin
NPI 1386138568

Casey Gerald Deshambo is a Student in an Organized Health Care Education/Training Program based in Green Bay, WI. Casey Gerald Deshambo practices in Green Bay, WI. The NPI Number for Casey Gerald Deshambo is 1386138568 and holds a License No. (Wisconsin).

The current practice location address for Casey Gerald Deshambo is 2100 Memorial Dr Apt 207, Green Bay, WI and can be reached out via phone at 906-399-6491.

Location: 2100 Memorial Dr Apt 207, Green Bay, WI, 54303-5309
person
Provider Profile Details
NPI Number
1386138568
Provider Name
Casey Gerald Deshambo
Credential
Provider Entity Type
Individual
Gender
Male
Address
2100 Memorial Dr Apt 207, Green Bay, WI, 54303-5309
Phone Number
906-399-6491
Fax Number
Provider Enumeration Date
06/20/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2100 Memorial Dr Apt 207
City
State
Zip
54303-5309
Phone Number
906-399-6491
Fax Number
person
Provider Business Mailing Address Details
Address
2100 Memorial Dr Apt 207
City
State
Zip
54303-5309
Phone Number
906-399-6491
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
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.
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