Provider Demographics
NPI:1578909735
Name:CASTILLO, ANGELA JOY
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:JOY
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6262 146TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-8946
Mailing Address - Country:US
Mailing Address - Phone:616-335-3456
Mailing Address - Fax:
Practice Address - Street 1:6262 146TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-8946
Practice Address - Country:US
Practice Address - Phone:616-335-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide