Provider Demographics
NPI:1295532059
Name:CASILLAS, SIERRA MARIE
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:MARIE
Last Name:CASILLAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:SIERRA
Other - Middle Name:MARIE
Other - Last Name:BURGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7836 OLD TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE BIRCH
Mailing Address - State:WV
Mailing Address - Zip Code:26629-9306
Mailing Address - Country:US
Mailing Address - Phone:681-837-9666
Mailing Address - Fax:
Practice Address - Street 1:101 2ND ST STE 201
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:WV
Practice Address - Zip Code:26601-1303
Practice Address - Country:US
Practice Address - Phone:304-765-3668
Practice Address - Fax:304-471-2488
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker