Provider Demographics
NPI:1598201535
Name:CASTILLE, SHANNA (LPN)
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:
Last Name:CASTILLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 PANDORA ST
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-5459
Mailing Address - Country:US
Mailing Address - Phone:281-813-5082
Mailing Address - Fax:
Practice Address - Street 1:12655 KUYKENDAHL RD
Practice Address - Street 2:6106
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-6931
Practice Address - Country:US
Practice Address - Phone:281-813-5082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-15
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No376J00000XNursing Service Related ProvidersHomemaker