GRACE COSTELLO


Address: 3625 University Blvd S, Jacksonville, FL 32216-4207
Phone: 9044212119

GRACE COSTELLO (NPI# 1326008046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326008046
Entity Type Individual
Full Name GRACE COSTELLO
Credential CRNA
Practice Address 3625 University Blvd S
Jacksonville
FL 32216-4207
Mailing Address Po Box 57100
Jacksonville
FL 32241-7100
Practice Telephone 9044212119
Enumeration Date 2006-03-25
Last Update Date 2020-10-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 367500000X Nurse Anesthetist, Certified Registered ARNP1427032 FL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL STATE LICENSE ARNP/RN1427032 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
4500 San Pablo Rd S, Jacksonville, FL 322241865 9049532000

Office Location

Street Address 3625 UNIVERSITY BLVD S
City JACKSONVILLE
State FL
Zip Code 32216-4207

Providers in the same location

NPI Name Taxonomy Address Enumeration
1588664395 Karen Elizabeth Anderson Anesthesiology 3625 University Blvd S, Jacksonville, FL 32216-4207 2005-07-22
1174122071 Deleah Rene Pickler Registered Nurse 3625 University Blvd S, Jacksonville, FL 32216-4207 2020-10-21
1801401641 Kara N Cordova Nurse Anesthetist, Certified Registered 3625 University Blvd S, Jacksonville, FL 32216-4222 2020-09-09
1174153654 Marina Follick Registered Nurse 3625 University Blvd S, Jacksonville, FL 32216-4207 2020-01-23
1649818337 Sarah Chapman Farris Registered Nurse 3625 University Blvd S, Jacksonville, FL 32216-4207 2019-12-13
1487291837 Lee Willingham Registered Nurse 3625 University Blvd S, Jacksonville, FL 32216-4207 2019-12-04
1609411586 Kyle Steven Scott Nurse Anesthetist, Certified Registered 3625 University Blvd S, Jacksonville, FL 32216-4222 2019-11-14
1982246328 Amy Marie Suralis Registered Nurse 3625 University Blvd S, Jacksonville, FL 32216-4207 2019-10-16
1396391991 Sarah Siebrandt Occupational Therapist 3625 University Blvd S, Jacksonville, FL 32216-4222 2019-08-11
1790347979 Leda Hansen Nurse Practitioner 3625 University Blvd S, Jacksonville, FL 32216-4207 2019-07-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1013524925 Renee Cherie Titus Behavior Technician Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 2020-09-24
1811546575 First Coast Orthopedic Center, LLC Clinic/Center 4035 Southpoint Boulevard, Jacksonville, FL 32216 2019-09-05
1922578558 Fatima Hussain Crofton Optometrist 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 2018-11-27
1154802833 John-paul Pham Internal Medicine 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 2018-08-22
1790279479 Joseph Richard Kennedy Physician Assistant 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 2018-06-18
1801304357 Kelli M. Tyson Nurse Practitioner 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 2018-01-18
1376054809 Angela M Whittinghill Counselor 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 2017-10-24
1629508072 Zoryana Yufan Dentist 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 2017-06-19
1700318896 Christina Kaczmarek Behavior Technician 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 2017-03-29
1932640422 Loudine Racius Nurse Practitioner 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 2017-03-16
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Taxonomy Information

Taxonomy Code 367500000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Anesthetist, Certified Registered

Taxonomy Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1992275572 William Lundgren Nurse Anesthetist, Certified Registered 3625 University Blvd South, Jacksonville, FL 32258 2018-11-27
1215436423 Jenitre Shavonne Moore Nurse Anesthetist, Certified Registered 5885 Edenfield Rd Apt L32, Jacksonville, FL 32277-1203 2018-02-03
1811402407 Aubrey Crowe Nurse Anesthetist, Certified Registered 1415 Windsor Pl, Jacksonville, FL 32205-7910 2017-12-05
1497294516 Megan Powell Nurse Anesthetist, Certified Registered 13003 Springs Manor Dr, Jacksonville, FL 32258-8437 2017-02-22
1679017123 Catherine Scanlon Nurse Anesthetist, Certified Registered 4635 Charles Bennett Dr, Jacksonville, FL 32225-1301 2016-12-16
1720444623 Katrina Canady Nurse Anesthetist, Certified Registered 13609 Devan Lee Dr E, Jacksonville, FL 32226-5810 2016-01-07
1104291822 Jenny Kambel Nurse Anesthetist, Certified Registered 13856 Herons Landing Way, Apt 5, Jacksonville, FL 32224-6065 2015-12-07
1609240746 Matthew James Dailey Nurse Anesthetist, Certified Registered 2500 San Pablo Rd S, Jacksonville, FL 32224 2015-11-29
1437540234 Catherine Simms Nurse Anesthetist, Certified Registered 400 Health Park Boulevard St., Jacksonville, FL 32086 2015-02-16
1699164889 Valerie Wolff Aquino Nurse Anesthetist, Certified Registered 8638 Stanmoor Ct, Jacksonville, FL 32244-7160 2015-01-12
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Competitor

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City JACKSONVILLE
Zip Code 32216

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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