Individual
MISS MICHELLE VALENTE COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2870
(203) 384-3000
Mailing address
19 LISA DR, SHELTON, CT 06484-2440
(203) 522-0068
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
10.219809
CT
363L00000X
Nurse Practitioner
Primary
12.010544
CT
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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