Healthcare Provider Details

I. General information

NPI: 1568389054
Provider Name (Legal Business Name): ERIC PAUL CASTILLO MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E 100 S APT 406
SALT LAKE CITY UT
84102-1912
US

IV. Provider business mailing address

555 E 100 S APT 406
SALT LAKE CITY UT
84102-1912
US

V. Phone/Fax

Practice location:
  • Phone: 801-949-9559
  • Fax:
Mailing address:
  • Phone: 801-949-9559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10944931-8900
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10944931-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: