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NPI Code Detail

MEDICARE: MS. PAULINE SOPHIE CASTILLO FNP

MEDICARE: MS. PAULINE SOPHIE CASTILLO FNP
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
1363LF0000XFamily Nurse Practitioner4815CO
2163W00000XRegistered Nurse164080CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427178722
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PAULINE SOPHIE CASTILLO FNP
Provider Business Mailing Address
First Line : 1401 ANITA ST.
Second Line :
City : PUEBLO
State : CO
Zip : 81001-2122
Country : US
Telephone Number : 719-225-6510
Fax Number : 719-542-3514
Provider Business Practice Location Address
First Line : 1401 ANITA ST
Second Line :
City : PUEBLO
State : CO
Zip : 81001-2122
Country : US
Telephone Number : 719-225-6510
Fax Number : 719-542-3514
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 02/17/2025

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