Healthcare Provider Details

I. General information

NPI: 1710561584
Provider Name (Legal Business Name): ASHLEY B CASTILLO APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2021
Last Update Date: 05/07/2021
Certification Date: 05/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 KINGS DAUGHTERS DR
FRANKFORT KY
40601-4186
US

IV. Provider business mailing address

321 LARCH LN
LEXINGTON KY
40511-2007
US

V. Phone/Fax

Practice location:
  • Phone: 524-050-2875
  • Fax:
Mailing address:
  • Phone: 859-408-6965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3015054
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number3015054
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: