Individual
MS. MEGAN CHRISTINE COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
4921 PARKVIEW PL, DIV SURG PLASTICS, STE 6G, SAINT LOUIS, MO 63110-1032
(314) 362-7388
(314) 367-0225
Mailing address
660 S EUCLID AVE, MSC 8238-43-1150, SAINT LOUIS, MO 63110-1010
(314) 362-7388
(314) 367-0225
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2020033731
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420091766
—
MO
Enumeration date
12/11/2020
Last updated
11/15/2021
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