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General NPI Number Information
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NPI Number | 1356190995
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Entity Type | Individual
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Provider Name | PAUL ANTHONY CASADOS PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 05/15/2024
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 1115 N GRAND AVE
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City | PUEBLO
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State | CO
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Zip | 81003-2867
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Country | US
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Telephone | 719-766-8511
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Fax |
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Provider Business Mailing Address
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Address Line | 2505 DAHLIA LN
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City | PUEBLO
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State | CO
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Zip | 81004-3630
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Country | US
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Telephone | 719-320-9072
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APN.0999732-NP
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License Number State | CO
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