Provider Demographics
NPI:1467831925
Name:CASTANEDA, JOANNA (FNP)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5713 82ND ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2633
Mailing Address - Country:US
Mailing Address - Phone:806-993-6560
Mailing Address - Fax:806-993-6565
Practice Address - Street 1:5713 82ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424
Practice Address - Country:US
Practice Address - Phone:806-993-6560
Practice Address - Fax:806-993-6565
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily