Provider Demographics
NPI:1477007334
Name:CASTEEL, LORI KAY (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:KAY
Last Name:CASTEEL
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:KAY
Other - Last Name:STORMENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:3190 HIGHWAY 95 LOT 2039
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-4308
Mailing Address - Country:US
Mailing Address - Phone:605-415-6067
Mailing Address - Fax:605-415-6067
Practice Address - Street 1:3190 HIGHWAY 95 LOT 2039
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-4308
Practice Address - Country:US
Practice Address - Phone:605-415-6067
Practice Address - Fax:605-415-6067
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR024302163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse