Healthcare Provider Details

I. General information

NPI: 1033280433
Provider Name (Legal Business Name): JEAN PODMORE CASTLE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 WT WEAVER BLVD
ASHEVILLE NC
28804-3415
US

IV. Provider business mailing address

38 STORIE BOOK LN
CANDLER NC
28715-8877
US

V. Phone/Fax

Practice location:
  • Phone: 828-771-3463
  • Fax: 828-257-4739
Mailing address:
  • Phone: 828-665-1386
  • Fax: 828-257-4739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number190887
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: