Provider Demographics
NPI:1578880639
Name:CASE, WILLIAM WALTER (PA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WALTER
Last Name:CASE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-282-7207
Mailing Address - Fax:515-282-7213
Practice Address - Street 1:604 LOCUST ST
Practice Address - Street 2:SUITE 210
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-3705
Practice Address - Country:US
Practice Address - Phone:515-282-7207
Practice Address - Fax:515-282-7213
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA629363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner