Individual
NICOLE COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
211 MAIN STREET, WATERVILLE, ME 04901
(207) 877-3450
(207) 872-7910
Mailing address
211 MAIN STREET, WATERVILLE, ME 04901
(207) 233-6708
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2633
ME
Other
Enumeration date
07/06/2023
Last updated
05/15/2025
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