Individual
CARRIE ANN MI COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
60 WESTWOOD AVE STE 100, WATERBURY, CT 06708-2460
(203) 578-4609
Mailing address
138 LITCHFIELD TPKE, BETHANY, CT 06524-3517
(203) 901-3695
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
459
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
459
CNM LICENSE
CT
Enumeration date
09/09/2019
Last updated
06/24/2023
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