Individual
MARA KELLY COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
2430 W HORIZON RIDGE PKWY, HENDERSON, NV 89052-2729
(702) 247-9994
(702) 651-9995
Mailing address
2430 W HORIZON RIDGE PKWY, HENDERSON, NV 89052-2729
(702) 247-9994
(702) 651-9995
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
822306
NV
Other
Enumeration date
07/23/2019
Last updated
08/23/2019
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