Provider Demographics
NPI:1013037068
Name:ROCKCASTLE, LOIS A (ANP)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:A
Last Name:ROCKCASTLE
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 BASHER DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1278
Mailing Address - Country:US
Mailing Address - Phone:907-337-2995
Mailing Address - Fax:
Practice Address - Street 1:3801 UNIVERSITY LAKE DR STE 205
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4658
Practice Address - Country:US
Practice Address - Phone:907-563-1600
Practice Address - Fax:907-563-0100
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK273363LF0000X
NYF330059-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily