Provider Demographics
NPI:1194997635
Name:CASTILLO, REBBECCA MARIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:REBBECCA
Middle Name:MARIE
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 BUTTERNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05301-8048
Mailing Address - Country:US
Mailing Address - Phone:802-579-5984
Mailing Address - Fax:
Practice Address - Street 1:94 POPLAR COMMONS
Practice Address - Street 2:
Practice Address - City:DUMMERSTON
Practice Address - State:VT
Practice Address - Zip Code:05301-9423
Practice Address - Country:US
Practice Address - Phone:802-257-7816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT025-0008768164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse