Provider Demographics
NPI:1659404440
Name:DE CASTRO, JILL SILVER (CFNP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:SILVER
Last Name:DE CASTRO
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:VANESSA
Other - Last Name:SILVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1620 PRESIDENT AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-7148
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:
Practice Address - Street 1:14001A SAINT GERMAIN DR
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2338
Practice Address - Country:US
Practice Address - Phone:703-830-8113
Practice Address - Fax:703-830-8276
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2296215363LF0000X
VA0024164627363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q78139Medicare UPIN
VA013210L19Medicare PIN
VAC06319Medicare PIN