Individual
MARY ELLEN P CASTRO
Active
Individual
MARY ELLEN P CASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
E48342
CT
363LA2200X
Adult Health Nurse Practitioner
Primary
001506
CT
363LG0600X
Gerontology Nurse Practitioner
001506
CT
364SM0705X
Medical-Surgical Clinical Nurse Specialist
001506
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004189579
—
CT
Enumeration date
02/17/2006
Last updated
03/03/2010
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