Individual
MS. ALENA NICOLE COSTULAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
520 S MUSTANG RD, YUKON, OK 73099-6737
(405) 936-5910
Mailing address
1802 ENNIS JOSLIN RD APT 531, CORPUS CHRISTI, TX 78412-4345
(724) 730-6299
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4902
OK
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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