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1477299139
JAMIE NICOLE COSTELLO
CHAMPAIGN, IL
NPI
1477299139
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209025184)
Enumeration Date
2022-05-06
Last Update Date
2023-11-29
Business Address
JAMIE NICOLE COSTELLO APRN
201 N RANDOLPH ST
CHAMPAIGN, IL 61820-3935
Phone number: 877-974-1653
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Mailing Address
JAMIE NICOLE COSTELLO APRN
2820 MARIETTA AVE
WATERFORD, MI 48329-3447
Phone number: 217-274-0787
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