Individual
DAVID COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.R.N.P.
Contact information
Practice address
4300 15TH ST, GULFPORT, MS 39501-2524
(228) 864-0828
Mailing address
12825 HANOVER DR, OCEAN SPRINGS, MS 39564-2612
(205) 470-3721
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1-064521
AL
363LF0000X
Family Nurse Practitioner
Primary
904287
MS
Other
Enumeration date
06/12/2009
Last updated
08/09/2022
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