Provider Demographics
NPI:1548842644
Name:CASTEEN, VICTORIA (RRT, RCP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:CASTEEN
Suffix:
Gender:F
Credentials:RRT, RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MILE 12 ROUTE 7
Mailing Address - Street 2:
Mailing Address - City:SAWMILL
Mailing Address - State:AZ
Mailing Address - Zip Code:86504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:835 N SPENCE AVE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4267
Practice Address - Country:US
Practice Address - Phone:919-222-6173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
227900000X
NCA10242279P4000X
NC1024227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Single Specialty
No2279P4000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPatient TransportGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA1024OtherRRT, RCP
NCA1024OtherREGISTERED RESPIRATORY THERAPIST