Provider Demographics
NPI:1568975605
Name:CANTRELL, WILLIAM DAVID (RN, NREMT-P)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVID
Last Name:CANTRELL
Suffix:
Gender:M
Credentials:RN, NREMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 NW VINCA LN
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7916
Mailing Address - Country:US
Mailing Address - Phone:360-606-4092
Mailing Address - Fax:
Practice Address - Street 1:1030 NW VINCA LN
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-7916
Practice Address - Country:US
Practice Address - Phone:360-606-4092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-12
Last Update Date:2017-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care