Provider Demographics
NPI:1790249373
Name:CASTRO, AMBER LAURA (BSN RN)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:LAURA
Last Name:CASTRO
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:MISS
Other - First Name:AMBER
Other - Middle Name:LAURA
Other - Last Name:NAUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN RN
Mailing Address - Street 1:8730 N HIMES AVE APT 808
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-8305
Mailing Address - Country:US
Mailing Address - Phone:801-628-0961
Mailing Address - Fax:
Practice Address - Street 1:750 W 800 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-3660
Practice Address - Country:US
Practice Address - Phone:801-714-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9479001163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse