Provider Demographics
NPI:1487905030
Name:CASTILLA, ANDREA KAE (ACNP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:KAE
Last Name:CASTILLA
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 HOSPITAL DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5701
Mailing Address - Country:US
Mailing Address - Phone:361-574-1782
Mailing Address - Fax:361-574-1783
Practice Address - Street 1:2710 HOSPITAL DR
Practice Address - Street 2:SUITE 304
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5701
Practice Address - Country:US
Practice Address - Phone:361-574-1782
Practice Address - Fax:361-574-1783
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-23
Last Update Date:2012-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX699082363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care