Provider Demographics
NPI:1427183458
Name:CASTEEL, TERESA LYNN (FNP)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:LYNN
Last Name:CASTEEL
Suffix:
Gender:F
Credentials:FNP
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Other - First Name:
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Mailing Address - Street 1:715 DR MARTIN LUTHER KING JR AVE NE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-3661
Mailing Address - Country:US
Mailing Address - Phone:505-727-7090
Mailing Address - Fax:505-727-7099
Practice Address - Street 1:715 DR MARTIN LUTHER KING JR AVE NE
Practice Address - Street 2:SUITE 301
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3661
Practice Address - Country:US
Practice Address - Phone:505-727-7090
Practice Address - Fax:505-727-7099
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR1565450163WR0006X
COAPN.0992244-NP363LF0000X
NMCNP-03000363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM42372348Medicaid