Individual
MARK DOMINIC CASTANAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
8116 LAS VEGAS BLVD S, LAS VEGAS, NV 89123-1015
(702) 407-7063
Mailing address
9722 GIFTHOUSE ST, LAS VEGAS, NV 89178-4866
(580) 917-1393
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
851962
NV
363LF0000X
Family Nurse Practitioner
Primary
851962
NV
Other
Enumeration date
07/19/2022
Last updated
08/03/2022
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