Costello-Wells, Brenda Lee

Costello-Wells, Brenda Lee is an individual health care provider with primary practice located at 1500 N Ritter Ave , Indianapolis IN 46219-3027. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Child & Adolescent, which is considered as her primary health care specialty. Costello-Wells, Brenda Lee can be contacted via phone (317) 355-2560.

Contact Information

Primary practice address
1500 N Ritter Ave Indianapolis IN 46219-3027
Phone: (317) 355-2560
Fax: (317) 355-2418
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Child & Adolescent 364SP0807X 70000059A Indiana

Profile Details

NPI number 1447258314
LBN Legal business name Costello-Wells, Brenda Lee
Credentials CNS APRN
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Nov 27th, 2023 - about 2 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 1447258314 NPPES
Indiana MEDICAID 100270530
Indiana MEDICAID 200223310

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