Healthcare Provider Details

I. General information

NPI: 1821732561
Provider Name (Legal Business Name): JANET LEE CASTLE LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 04/27/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 4TH AVE
HUNTINGTON WV
25701-1219
US

IV. Provider business mailing address

135 4TH AVE
HUNTINGTON WV
25701-1219
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-5691
  • Fax: 304-525-5693
Mailing address:
  • Phone: 304-525-5691
  • Fax: 304-525-5693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number33025
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: