Provider Demographics
NPI:1912867961
Name:CASTO, JENNIFER (RN, LCCE)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CASTO
Suffix:
Gender:F
Credentials:RN, LCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 RAVINIA RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-1844
Mailing Address - Country:US
Mailing Address - Phone:304-951-0595
Mailing Address - Fax:
Practice Address - Street 1:1528 RAVINIA RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314-1844
Practice Address - Country:US
Practice Address - Phone:304-951-0595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-13
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV124276163WP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatal