Costello, Merissa L

Costello, Merissa L is an individual health care provider with primary practice located at 1115 Boulders Pkwy Ste 200 , North Chesterfield VA 23225. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Costello, Merissa L can be contacted via phone (804) 560-5595.

Contact Information

Primary practice address
1115 Boulders Pkwy Ste 200 North Chesterfield VA 23225
Phone: (804) 560-5595
Fax: (804) 590-9029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 0024167442 Virginia

Profile Details

NPI number 1780845362
LBN Legal business name Costello, Merissa L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2008
Last updated Jun 1st, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780845362 NPPES
Other 12337630 CAQH

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