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Individual
MS. MICHELLE CORONA COSTLEY
Active
Individual
MS. MICHELLE CORONA COSTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
670483
TX
363LF0000X
Family Nurse Practitioner
Primary
AP13866
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286369805
—
TX
01
—
H08MK73201
BCBS
TX
Enumeration date
01/05/2011
Last updated
04/27/2020
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