1134212939 NPI number — MRS. DEBRA CASTNER NP,RN, MSN, APRN,CNN

Table of content: MRS. DEBRA CASTNER NP,RN, MSN, APRN,CNN (NPI 1134212939)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134212939 NPI number — MRS. DEBRA CASTNER NP,RN, MSN, APRN,CNN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASTNER
Provider First Name:
DEBRA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP,RN, MSN, APRN,CNN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134212939
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6160 KEMPSVILLE CIR STE 302A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23502-3936
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-466-9288
Provider Business Mailing Address Fax Number:
757-457-3691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9550 HOSPITAL AVE
Provider Second Line Business Practice Location Address:
PO BOX 923
Provider Business Practice Location Address City Name:
NASSAWADOX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-442-9080
Provider Business Practice Location Address Fax Number:
757-442-9082
Provider Enumeration Date:
10/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  26NO06161900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2100X , with the licence number: 0024172475 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 26NO06161900 . This is a "RN/APRN LICENSE NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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