Individual
MICAELA GRACE COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
21 IVY MEADOWS LN, WESTPORT, MA 02790-4951
(508) 523-1883
Mailing address
21 IVY MEADOWS LN, WESTPORT, MA 02790-4951
(508) 523-1883
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2302436
MA
Other
Enumeration date
06/30/2023
Last updated
04/23/2024
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