Healthcare Provider Details

I. General information

NPI: 1548418114
Provider Name (Legal Business Name): ROBIN MICHELLE DECASTRO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 W 4TH ST
GILLETTE WY
82716-3328
US

IV. Provider business mailing address

1414 W 4TH ST
GILLETTE WY
82716-3328
US

V. Phone/Fax

Practice location:
  • Phone: 307-682-6263
  • Fax: 307-682-2024
Mailing address:
  • Phone: 307-682-6263
  • Fax: 307-682-2024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-76831-101
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number18154.0972
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: