Healthcare Provider Details

I. General information

NPI: 1811682396
Provider Name (Legal Business Name): MARCELLA NICOLE CASTILLO APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3195 SAINT ROSE PKWY STE 210
HENDERSON NV
89052-3504
US

IV. Provider business mailing address

3195 SAINT ROSE PKWY STE 210
HENDERSON NV
89052-3504
US

V. Phone/Fax

Practice location:
  • Phone: 702-792-6700
  • Fax:
Mailing address:
  • Phone: 702-792-6700
  • Fax: 702-792-7198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number865089
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: