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General NPI Number Information
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NPI Number | 1760348304
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Entity Type | Individual
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Provider Name | GRACIE CASTILLO
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Gender | Female
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 2250 N MILLER CAMPUS DR
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City | LEHI
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State | UT
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Zip | 84048-7233
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Country | US
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Telephone | 435-374-9004
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Fax | 435-374-9004
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Provider Business Mailing Address
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Address Line | 131 N 1200 E
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City | LINDON
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State | UT
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Zip | 84042-2257
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Country | US
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Telephone | 435-374-9004
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Fax | 435-374-9004
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 13449079-3102
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License Number State | UT
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