Provider Demographics
NPI:1205325990
Name:CASTILLO, BRITTANY CHENELLE
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:CHENELLE
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 1:2901 ARUNDEL RD APT 304
Mailing Address - Street 2:
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1617
Mailing Address - Country:US
Mailing Address - Phone:202-424-3039
Mailing Address - Fax:
Practice Address - Street 1:2901 ARUNDEL RD APT 304
Practice Address - Street 2:
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-1617
Practice Address - Country:US
Practice Address - Phone:202-424-3039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant