Individual provider · Type 1 NPI

David Costello, C.R.N.P.

Family Nurse Practitioner · Gulfport, MS

NPI number 1104053420 Active

Practice location

4300 15th St
Gulfport, MS 39501-2524

Mailing address

12825 Hanover Dr
Ocean Springs, MS 39564-2612

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000X1-064521 (AL)
Family Nurse Practitioner Primary 363LF0000X904287 (MS)

Family Nurse Practitioner: Definition to come...

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About NPI 1104053420

David Costello, C.R.N.P.'s National Provider Identifier is 1104053420, issued on Jun 12, 2009. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Gulfport, MS. The record was last updated on Aug 9, 2022.