Provider Demographics
NPI:1073646931
Name:CASTLE, SHELLEY ANN (CRNP-A)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:ANN
Last Name:CASTLE
Suffix:
Gender:F
Credentials:CRNP-A
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:
Other - Last Name:ROWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11350 MCCORMICK RD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, SUITE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-1002
Mailing Address - Country:US
Mailing Address - Phone:301-665-9696
Mailing Address - Fax:240-420-5715
Practice Address - Street 1:1150 PROFESSIONAL CT
Practice Address - Street 2:SUITE P
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4100
Practice Address - Country:US
Practice Address - Phone:301-665-9696
Practice Address - Fax:240-420-5715
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011685363LA2200X
MDR135318363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR135318OtherMARYLAND BOARD OF NURSING