MRS. ATHENA LEE CASTILLEJA EZERNACK IDMT
NPI 1790014660
Military Health Care Provider - Independent Duty Medical Technicians in Barksdale Afb, LA

Active since December 23, 2009
407 BARKSDALE BLVD E, BARKSDALE AFB, LA 71110(318) 456-6165 Get Directions Write a Review

NPPES record last updated: December 23, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Athena Lee Castilleja Ezernack Idmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. ATHENA LEE CASTILLEJA EZERNACK IDMT (NPI 1790014660) is an individual independent duty medical technicians provider in Barksdale Afb, Louisiana and active in the NPI registry since December 2009.

NPPES Registry Identity

NPI1790014660
Entity TypeIndividualFemale
Primary Taxonomy1710I1003X
Provider Legal NameMRS. ATHENA LEE CASTILLEJA EZERNACKCredential: IDMT
Location Address407 BARKSDALE BLVD EBarksdale Afb, LA 71110-2125
Mailing Address407 Barksdale Blvd EBarksdale Afb, LA 71110-2125 · (318) 456-6165
Sole ProprietorNo
Enumeration DateDecember 23, 2009
NPI 1790014660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code1710I1003X
Definition
An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
407 BARKSDALE BLVD E, Barksdale Afb, LA 71110

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Athena Castilleja Ezernack's NPI number?

The NPI number for Athena Castilleja Ezernack is 1790014660. It was assigned to this individual provider in the NPPES registry on December 23, 2009.

Where is Athena Castilleja Ezernack located?

Athena Castilleja Ezernack practices at 407 Barksdale Blvd E, Barksdale Afb, LA 71110. The listed phone number is (318) 456-6165.

What is Athena Castilleja Ezernack's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Medical Technicians, with taxonomy code 1710I1003X.

When was this NPI record last updated?

The NPPES record for Athena Castilleja Ezernack was last updated on December 23, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.