Individual
ANNE C COSTELLO JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,CRNP
Contact information
Practice address
1203 LANGHORNE NEWTOWN RD, SUITE 226, LANGHORNE, PA 19047-1209
(215) 752-3330
(215) 752-2004
Mailing address
1203 LANGHORNE NEWTOWN RD, SUITE 226, LANGHORNE, PA 19047-1209
(215) 752-3330
(215) 752-2004
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP010947
PA
Other
Enumeration date
09/30/2011
Last updated
09/30/2011
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