Individual
MR. JARED DANIEL COSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
975 E 3RD ST, CHATTANOOGA, TN 37403-2147
(423) 778-9001
Mailing address
621 MEMORIAL DR APT 1706, CHATTANOOGA, TN 37415-5526
(336) 816-0087
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
25536
TN
Other
Enumeration date
06/14/2019
Last updated
06/14/2019
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