Provider Demographics
NPI:1114550993
Name:CASTILLO, FAITH LYNN (FNP)
Entity type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:LYNN
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:FAITH
Other - Middle Name:LYNN
Other - Last Name:PLETCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:4755 COUNTRY CLUB RD APT 113N
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-3513
Mailing Address - Country:US
Mailing Address - Phone:336-999-4246
Mailing Address - Fax:
Practice Address - Street 1:4755 COUNTRY CLUB RD APT 113N
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-3513
Practice Address - Country:US
Practice Address - Phone:336-999-4246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC280050163W00000X
NC5013595363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse