Individual
DEVAN COSTELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APRN, AGACNP-BC
Contact information
Practice address
201 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202-3841
(502) 718-2877
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0325
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
3013580
KY
Other
Enumeration date
07/24/2019
Last updated
08/23/2019
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