Individual
CANDICE COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
593 HERCULES DR, COLCHESTER, VT 05446-5993
(802) 488-5350
Mailing address
PO BOX 235, JOHNSON, VT 05656-0235
(802) 279-2755
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
026.0033197
VT
Other
Enumeration date
12/10/2020
Last updated
12/12/2020
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