Provider Demographics
NPI:1003412719
Name:CASTELLANO, NICOLE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:CASTELLANO
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11555 MAGNOLIA PKWY STE 190
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2146
Mailing Address - Country:US
Mailing Address - Phone:281-809-3664
Mailing Address - Fax:
Practice Address - Street 1:11555 MAGNOLIA PKWY STE 190
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2146
Practice Address - Country:US
Practice Address - Phone:281-809-3664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV836348363LF0000X
TX1060373363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily