Provider Demographics
NPI:1780483057
Name:KASTELLA, DENIELLE
Entity type:Individual
Prefix:
First Name:DENIELLE
Middle Name:
Last Name:KASTELLA
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 CASCADE LOOP
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-7370
Mailing Address - Country:US
Mailing Address - Phone:406-314-4788
Mailing Address - Fax:
Practice Address - Street 1:505 CASCADE LOOP
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-7370
Practice Address - Country:US
Practice Address - Phone:406-314-4788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PAC-LIC-164627207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology