Provider Demographics
NPI:1558703918
Name:CASTILLO, NICHOLE TRUMPER (APRN, CNP)
Entity Type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:TRUMPER
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:MRS
Other - First Name:NICHOLE
Other - Middle Name:ANNE
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:763-873-3000
Mailing Address - Fax:612-873-1928
Practice Address - Street 1:715 S 8TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-6963
Practice Address - Fax:612-873-1928
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2067805163WP0200X
MN2253363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics