Individual
MRS. DIANE MARIE COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
42 BASSWOOD DR, BRISTOL, RI 02809-4912
(401) 424-1825
(937) 606-3077
Mailing address
42 BASSWOOD DR, BRISTOL, RI 02809-4912
(401) 655-2031
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
CAPRN01044
RI
363LG0600X
Gerontology Nurse Practitioner
Primary
NPP37575
RI
Other
Enumeration date
09/22/2010
Last updated
06/15/2023
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