Individual
AUDRA COSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1171 107TH ST, GRAND PRAIRIE, TX 75050-2502
(972) 597-0843
Mailing address
1171 107TH ST, GRAND PRAIRIE, TX 75050-2502
(972) 597-0843
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP146041
TX
Other
Enumeration date
08/03/2020
Last updated
11/03/2020
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