Provider Demographics
NPI:1407213291
Name:DECASTRO, ROSSANNE (MSN, PHN, RN, CNS)
Entity Type:Individual
Prefix:
First Name:ROSSANNE
Middle Name:
Last Name:DECASTRO
Suffix:
Gender:F
Credentials:MSN, PHN, RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 WALLACE AVE
Mailing Address - Street 2:4TH FLOOR ROOM 402
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-2312
Mailing Address - Country:US
Mailing Address - Phone:412-247-7817
Mailing Address - Fax:
Practice Address - Street 1:807 WALLACE AVE
Practice Address - Street 2:4TH FLOOR ROOM 402
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-2312
Practice Address - Country:US
Practice Address - Phone:412-247-7817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA666457163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse