Costanzo, Erin R
Costanzo, Erin R is an individual health care provider with primary practice located at 7869 Villa Rica Hwy , Dallas GA 30157. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Costanzo, Erin R can be contacted via phone (770) 459-4411.Contact Information
Primary practice address
7869 Villa Rica Hwy
Dallas GA 30157
Phone: (770) 459-4411
Fax: (770) 459-2424
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN146776NP | Georgia |
Profile Details
NPI number | 1649244997 |
---|---|
LBN Legal business name | Costanzo, Erin R |
Credentials | APRN FNPC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 14th, 2006 |
Last updated | Jan 19th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1649244997 | NPPES |
Georgia | MEDICAID | 453616500A | |
Georgia | MEDICAID | 453616500B |
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