| NPI | 1346622487 |
|---|---|
| Former Name | JAMIE J. COSTANZO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000815) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0036412) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2020-03-13 |