Provider Demographics
NPI:1326757428
Name:CASTRO, XIMENA ARIELA (AGNP-C)
Entity type:Individual
Prefix:
First Name:XIMENA
Middle Name:ARIELA
Last Name:CASTRO
Suffix:
Gender:
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 JESSE JEWELL PKWY SE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3834
Mailing Address - Country:US
Mailing Address - Phone:770-535-0191
Mailing Address - Fax:770-535-0916
Practice Address - Street 1:725 JESSE JEWELL PKWY SE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3834
Practice Address - Country:US
Practice Address - Phone:705-350-1917
Practice Address - Fax:770-535-0916
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN265555363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty