Individual provider · Type 1 NPI
Jillian Marie Costello, CRNP
Acute Care Nurse Practitioner · Philadelphia, PA
NPI number
1649862103
Active
Practice location
111 S 11th St
Philadelphia, PA 19107-4824
Mailing address
401 S Iseminger St
Philadelphia, PA 19147-1113
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | SP023213 (PA) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1649862103
Jillian Marie Costello, CRNP's National Provider Identifier is 1649862103, issued on Feb 6, 2021. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Philadelphia, PA. The record was last updated on Feb 6, 2021.