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Carla C Costello, FNP
Family Nurse Practitioner in Lake Providence, Louisiana
NPI 1356657746

Carla C Costello is a Family Nurse Practitioner based in Lake Providence, LA and is specialized in Family. Carla C Costello practices in Lake Providence, LA and has the professional credentials of FNP. The NPI Number for Carla C Costello is 1356657746 and holds a License No. RN095103 AP06260 (Louisiana).

The current practice location address for Carla C Costello is 320 N Hood St, Lake Providence, LA and can be reached out via phone at 318-559-2404.

Location: 320 N Hood St, Lake Providence, LA, 71254-2140
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356657746
Provider Name
Carla C Costello
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
320 N Hood St, Lake Providence, LA, 71254-2140
Phone Number
318-559-2404
Fax Number
Provider Enumeration Date
08/24/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2121286 05 LA
AP06260 01 LA STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
320 N Hood St
City
Lake Providence
State
Louisiana
Zip
71254-2140
Phone Number
318-559-2404
Fax Number
person
Provider Business Mailing Address Details
Address
320 N Hood St
City
Lake Providence
State
Louisiana
Zip
71254-2140
Phone Number
318-559-2404
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
RN095103 AP06260 (Louisiana)
Definition
Definition to come...
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