Provider Demographics
NPI:1467139766
Name:CASTILLE-BUTTS, TAWANA LOUISE (RN)
Entity Type:Individual
Prefix:MS
First Name:TAWANA
Middle Name:LOUISE
Last Name:CASTILLE-BUTTS
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 1:3149 AMBASSADOR CAFFERY PKWY # A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-7209
Mailing Address - Country:US
Mailing Address - Phone:337-706-3415
Mailing Address - Fax:337-706-3460
Practice Address - Street 1:3149 AMBASSADOR CAFFERY PKWY # A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-7209
Practice Address - Country:US
Practice Address - Phone:337-706-3415
Practice Address - Fax:337-706-3460
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN097193163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse