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Individual

MARIA KOSTANTACOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP

Contact information

Practice address
1010 N WASHINGTON ST, JANESVILLE, WI 53548-1500
(608) 741-3800
(608) 741-3838
Mailing address
1010 N WASHINGTON ST, JANESVILLE, WI 53548-1500
(608) 741-3800
(608) 741-3838

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
041343430
IL
163WR0006X
Registered Nurse First Assistant
148040
WI
363LF0000X
Family Nurse Practitioner
Primary
5492-33
WI

Other

Enumeration date
09/23/2009
Last updated
10/02/2013
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