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Individual

JENNA MARIANNA COSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN/CRNA

Contact information

Practice address
5352 LINTON BLVD, DELRAY BEACH, FL 33484-6514
(561) 498-4440
Mailing address
445 NE 37TH ST, BOCA RATON, FL 33431-5925
(862) 377-8564

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9487244
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11004317
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
APRN11004317
STATE LICENSE
FL
Enumeration date
09/08/2019
Last updated
12/06/2024
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