Individual
DANNIAL RENE COSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 MAIN ST NE STE A, LOS LUNAS, NM 87031-7421
(505) 565-0070
Mailing address
12127 N STATE HWY 14 STE 5, CEDAR CREST, NM 87008-9461
(505) 281-2460
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
65970
NM
Other
Enumeration date
01/21/2022
Last updated
01/21/2022
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