Individual provider · Type 1 NPI

Michelle Lyn Costlow, PMHNP-BC

Psychiatric/Mental Health Nurse Practitioner · Tyler, TX

NPI number 1447966262 Active

Practice location

121 S Broadway Ave Ste 608
Tyler, TX 75702-7281

Call (888) 360-7587 Map

Fax (979) 446-0280

Mailing address

1511 Texas Ave S Pmb 233, Pmb 233
Bryan, TX 77802-3475

Other practice locations

  • 500 Marquette Ave NW Ste 1200, Albuquerque, NM 87102-5312 · (888) 360-7587
  • 3201 University Dr E Ste 240, Bryan, TX 77802-3475 · (888) 360-7587
  • 7535 E Hampden Ave Ste 400, Denver, CO 80231-4844 · (888) 360-7587

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X1099356 (TX)
Psychiatric/Mental Health Nurse Practitioner 363LP0808X74683 (NM)
Psychiatric/Mental Health Nurse Practitioner 363LP0808XC-APN.0101005-C-NP (CO)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1447966262

Michelle Lyn Costlow, PMHNP-BC's National Provider Identifier is 1447966262, issued on Jan 25, 2023. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Tyler, TX. The record was last updated on Dec 12, 2025.