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1467162792
DERONDA COSTILOW
TUPELO, MS
NPI
1467162792
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: MS 862114)
Enumeration Date
2022-11-28
Last Update Date
2022-11-28
Business Address
DERONDA COSTILOW
2434 S EASON BLVD
TUPELO, MS 38804-6942
Phone number: 662-640-4595
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Mailing Address
DERONDA COSTILOW
2434 S EASON BLVD
TUPELO, MS 38804-6942
Phone number: 662-640-4595
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