Provider Demographics
NPI:1316180763
Name:NICASTRO, JOANNE F (MSN, NP)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:F
Last Name:NICASTRO
Suffix:
Gender:F
Credentials:MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 569
Mailing Address - Street 2:
Mailing Address - City:RANGELEY
Mailing Address - State:ME
Mailing Address - Zip Code:04970-0569
Mailing Address - Country:US
Mailing Address - Phone:207-864-2699
Mailing Address - Fax:207-864-2969
Practice Address - Street 1:32 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:ME
Practice Address - Zip Code:04217
Practice Address - Country:US
Practice Address - Phone:207-824-2193
Practice Address - Fax:207-824-3005
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP91014363L00000X
MEAP091014363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner