Provider Demographics
NPI:1518326230
Name:CASTILLO, WENDY L (CRNP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-273-4159
Mailing Address - Fax:334-273-4290
Practice Address - Street 1:470 TAYLOR RD STE 310
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7130
Practice Address - Country:US
Practice Address - Phone:334-244-4322
Practice Address - Fax:334-244-4321
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004424363LF0000X
AL1-121385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily