Individual
SHAWN KUDRIK COSTANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
62 DENVER RIDGE RD, OLD FORT, NC 28762-9785
(828) 779-2269
Mailing address
62 DENVER RIDGE RD, OLD FORT, NC 28762-9785
(828) 779-2269
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
285954
NC
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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