Individual
JUDY CASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD., PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2016043422
MO
363LP0200X
Pediatric Nurse Practitioner
77479
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118927606
—
TX
Enumeration date
03/24/2011
Last updated
11/27/2017
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