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General NPI Number Information
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NPI Number | 1851145346
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Entity Type | Individual
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Provider Name | LINH LE MAI NGUYEN DE CASTRO DNP, ARNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/12/2024
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 2103 COUNTY ROAD D E STE B
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City | MAPLEWOOD
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State | MN
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Zip | 55109-5358
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Country | US
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Telephone | 612-915-0049
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Fax |
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Provider Business Mailing Address
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Address Line | 360 SHERMAN ST STE 390
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City | SAINT PAUL
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State | MN
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Zip | 55102-3865
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Country | US
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Telephone | 651-383-4800
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2482966
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 160483
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11514
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License Number State | MN
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