Provider Demographics
NPI:1508287269
Name:HOMESTEAD, NATHANIEL D (LSW)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:D
Last Name:HOMESTEAD
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8553
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89507-8553
Mailing Address - Country:US
Mailing Address - Phone:775-781-7894
Mailing Address - Fax:
Practice Address - Street 1:1575 DELUCCHI LN STE 220
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-8521
Practice Address - Country:US
Practice Address - Phone:775-825-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-26
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor