Healthcare Provider Details

I. General information

NPI: 1801362199
Provider Name (Legal Business Name): CHRISTOPHER CASTELLO FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 2ND ST SE
CUT BANK MT
59427-3329
US

IV. Provider business mailing address

802 2ND ST SE
CUT BANK MT
59427-3329
US

V. Phone/Fax

Practice location:
  • Phone: 406-873-2251
  • Fax: 406-873-3118
Mailing address:
  • Phone: 406-873-2251
  • Fax: 406-873-3118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71010342A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number132522
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: