Individual
MRS. LAUREN MELISSA CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2409 N PATTERSON ST STE 200, VALDOSTA, GA 31602-2512
(229) 333-1711
Mailing address
255 CONINE RD, LAKELAND, GA 31635-5403
(229) 269-7487
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN251943
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019049126
ANCC CERTIFICATION
GA
01
—
RN251943
APRN LICENSURE
GA
Enumeration date
03/03/2021
Last updated
03/03/2021
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