Healthcare Provider Details

I. General information

NPI: 1962470757
Provider Name (Legal Business Name): KATHY JEANETTE CASTILLE- ALIFFI APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S PARK ST STE A
MADISON WI
53715-1830
US

IV. Provider business mailing address

20 FRANCIS WAY SUITE 101
SHARPSBURG GA
30277
US

V. Phone/Fax

Practice location:
  • Phone: 608-260-2900
  • Fax: 608-260-2956
Mailing address:
  • Phone: 770-253-0611
  • Fax: 770-716-0087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number16192-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number089463
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: