Healthcare Provider Details

I. General information

NPI: 1861227860
Provider Name (Legal Business Name): MARIBEL CASTELLANOS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 W WASHINGTON ST STE 2
JEFFERSON IA
50129-1901
US

IV. Provider business mailing address

1215 DUFF AVE
AMES IA
50010-5469
US

V. Phone/Fax

Practice location:
  • Phone: 515-386-4192
  • Fax:
Mailing address:
  • Phone: 515-239-4418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA180209
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA180209
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: