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1417398124
MARY KEELY COSTELLO BENNETT
RICHMOND, VA
NPI
1417398124
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: VA 0024170989)
Enumeration Date
2013-07-10
Last Update Date
2019-02-07
Business Address
Mrs. MARY KEELY COSTELLO BENNETT AGACNP-BC
1250 E MARSHALL ST EMERGENCY MEDICINE
RICHMOND, VA 23298-5051
Phone number: 804-828-5650
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Mailing Address
Mrs. MARY KEELY COSTELLO BENNETT AGACNP-BC
PO BOX 91734
RICHMOND, VA 23291-1734
Phone number: 804-358-6100
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