Provider Demographics
NPI:1558736504
Name:COLE, LAURA CASTILLO (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:CASTILLO
Last Name:COLE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:CASTILLO
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:5021 CROSSROADS DRIVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932
Mailing Address - Country:US
Mailing Address - Phone:915-790-5700
Mailing Address - Fax:915-521-7842
Practice Address - Street 1:5021 CROSSROADS DRIVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932
Practice Address - Country:US
Practice Address - Phone:915-790-5700
Practice Address - Fax:915-521-7842
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129183363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner