MEDICARE: BRITTANY CASTLE PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA2672	KY
2	363AS0400X	Surgical Physician Assistant	PA2672	KY
3	363A00000X	Physician Assistant	PA2672	KY

General Provider Information

NPI Number	:	1356951990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY CASTLE PA-C

Provider Business Mailing Address
First Line	:	3540 CREEKWOOD DR APT 9
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-6531
Country	:	US
Telephone Number	:	859-619-6646
Fax Number	:

Provider Business Practice Location Address
First Line	:	740 S LIMESTONE
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40536-8630
Country	:	US
Telephone Number	:	859-323-5661
Fax Number	:	859-323-6411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2020
Last Update Date	:	02/15/2022

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Directions to “ BRITTANY CASTLE PA-C” Practice Location

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