Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 14131 | CA |
NPI | 1023051869 |
---|---|
Provider Name | Mrs. Nicole Denise Kastner |
First Address | Carlsbad, CA 92010-2836 |
Second Address | San Diego, CA 92120-5003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 08/07/2007 |