| NPI | 1649288440 |
|---|---|
| Former Name | KRISTEN MARIE COSTELLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH NP07195) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN 286828) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2014-06-02 |