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1184968133
JOHNNA SUZANNE COSTELLO
WICHITA, KS
NPI
1184968133
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Former Name
JOHNNA SUZANNE WENDT
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: KS 53-75854-011)
Enumeration Date
2012-11-15
Last Update Date
2016-09-30
Business Address
JOHNNA SUZANNE COSTELLO FNP-C
3311 E MURDOCK ST
WICHITA, KS 67208-3054
Phone number: 316-689-9107
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Mailing Address
JOHNNA SUZANNE COSTELLO FNP-C
PO BOX 8035
WICHITA, KS 67208-0035
Phone number: 316-689-9135
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