Provider Demographics
NPI:1699920751
Name:CASTANO, OLGA LUCIA (NP)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:LUCIA
Last Name:CASTANO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4652 SHALLOW SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-5319
Mailing Address - Country:US
Mailing Address - Phone:678-567-9801
Mailing Address - Fax:678-567-9801
Practice Address - Street 1:4652 SHALLOW SPRINGS CT
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-5319
Practice Address - Country:US
Practice Address - Phone:678-567-9801
Practice Address - Fax:678-567-9801
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA216124363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily