MEDICARE: MRS. PATRICIA D CASTLEMAN FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	APN38160	TN

General Provider Information

NPI Number	:	1164405221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA D CASTLEMAN FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 689
Second Line	:
City	:	WAYNESBORO
State	:	TN
Zip	:	38485-0689
Country	:	US
Telephone Number	:	931-722-2800
Fax Number	:	931-722-9627

Provider Business Practice Location Address
First Line	:	107 JV MANGUBAT DR
Second Line	:
City	:	WAYNESBORO
State	:	TN
Zip	:	38485-2440
Country	:	US
Telephone Number	:	931-722-2800
Fax Number	:	931-722-9627

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	02/19/2014

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