Provider Demographics
NPI:1720289986
Name:CASTEEL, EMOGENE
Entity Type:Individual
Prefix:MRS
First Name:EMOGENE
Middle Name:
Last Name:CASTEEL
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 1:1990 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:CROWN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45623-9172
Mailing Address - Country:US
Mailing Address - Phone:740-256-1087
Mailing Address - Fax:
Practice Address - Street 1:1990 DAVIS RD
Practice Address - Street 2:
Practice Address - City:CROWN CITY
Practice Address - State:OH
Practice Address - Zip Code:45623-9172
Practice Address - Country:US
Practice Address - Phone:740-256-1087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN310178163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2592903Medicaid