NPI | 1285032268 |
---|---|
Former Name | NICOLE CASTLEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60514722) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA15814) |
363A00000X Physician Assistant (Licence: NC 0010-13108) | |
363A00000X Physician Assistant (Licence: SC 4860) | |
363A00000X Physician Assistant (Licence: NY 1547278) | |
363A00000X Physician Assistant (Licence: CO PA.0007287) | |
363A00000X Physician Assistant (Licence: GA 11030) | |
363A00000X Physician Assistant (Licence: AZ 5845) | |
363A00000X Physician Assistant (Licence: MD C0008248) | |
Enumeration Date | 2014-12-08 |
Last Update Date | 2023-05-12 |