Provider Demographics
NPI:1033280433
Name:CASTLE, JEAN PODMORE (RN)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:PODMORE
Last Name:CASTLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 STORIE BOOK LN
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-8877
Mailing Address - Country:US
Mailing Address - Phone:828-665-1386
Mailing Address - Fax:828-257-4739
Practice Address - Street 1:118 WT WEAVER BLVD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-3415
Practice Address - Country:US
Practice Address - Phone:828-771-3463
Practice Address - Fax:828-257-4739
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC190887163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC190887OtherRN LICENSE