Individual
MRS. CAROLYN S COSTELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN APRN BC
Contact information
Practice address
1010 KINGS HWY S STE 2101, CHERRY HILL, NJ 08034-2524
(856) 208-7300
(856) 254-0019
Mailing address
1010 KINGS HWY S STE 2101, CHERRY HILL, NJ 08034-2524
(856) 208-7300
(856) 254-0019
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR10857800
NJ
363L00000X
Nurse Practitioner
26NJ00041700
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00041700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0183946
—
NJ
05
—
0305715
—
NJ
Enumeration date
02/28/2007
Last updated
06/02/2025
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