Provider Demographics
NPI:1154796845
Name:CASTANEDA, FERNANDA (APRN)
Entity type:Individual
Prefix:MRS
First Name:FERNANDA
Middle Name:
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:FERNANDA
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 746093
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6093
Mailing Address - Country:US
Mailing Address - Phone:773-759-7550
Mailing Address - Fax:312-929-0373
Practice Address - Street 1:183 W APACHE TRL # B109
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-3425
Practice Address - Country:US
Practice Address - Phone:480-887-9743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-06
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ229675363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily