Individual
NANETTE K COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
155 MEMORIAL DR, PINEHURST, NC 28374-8710
(910) 715-1010
(910) 715-1026
Mailing address
PO BOX 400010, LAS VEGAS, NV 89140-0010
(702) 214-9741
(702) 543-4326
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN001093
NV
367500000X
Certified Registered Nurse Anesthetist
6263
NC
Other
Enumeration date
03/04/2009
Last updated
04/12/2021
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