JENNIFER COSTELLO (NPI# 1346711223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346711223 |
| Entity Type | Individual |
| Full Name | JENNIFER COSTELLO |
| Credential | AGACNP |
| Practice Address |
111 S 11th St Philadelphia PA 19107-4824 |
| Mailing Address |
5250 Ridge Ave Philadelphia PA 19128-3712 |
| Practice Telephone | 2159554535 |
| Practice Fax Number | 2155035939 |
| Mailing Telephone | 5702590848 |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
SP019737 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | STATE BOARD OF NURSING | SP019737 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538705694 | Jennifer Costello | Nurse Practitioner | 336 Forest St, Lagrange, OH 44050-9685 | 2019-11-25 |
| 1538649546 | Jennifer Costello | Registered Nurse | 5718 Spanish Dawn, San Antonio, TX 78222-3470 | 2018-08-19 |
| 1548621634 | Jennifer Ann Costello | Social Worker | 157 Fisher Ave, Suite 9, Eastchester, NY 10709-2600 | 2016-03-16 |
| 1104075746 | Jennifer A Costello | Social Worker | 329 Malapardis Rd, Morris Plains, NJ 07950-3261 | 2008-09-18 |
| 1205091832 | Jennifer Beth Costello | Counselor | 11 Glenview St, Upton, MA 01568-1336 | 2008-07-23 |
| 1619506250 | Jennifer Rebecca Costello | Social Worker | 41840 Enterprise Cir N, Temecula, CA 92590-5654 | 2020-04-06 |
| 1497111314 | Jennifer Costello | Counselor | 156 S State St, Dover, DE 19901-7314 | 2016-01-07 |
| 1659798205 | Jennifer Costello | Social Worker | 6601 North Ave, Oak Park, IL 60302 | 2014-03-20 |
| 1205251139 | Jennifer Ann Costello | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2014-03-01 |
| 1033468061 | Jennifer Costello | Registered Nurse | 911 W Hudson Blvd, Gastonia, NC 28052-6430 | 2012-09-06 |
| Street Address |
111 S 11TH ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-4824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346246642 | Flavius F. Guglielmo | Radiology | 111 S 11th St, Suite 3390, Philadelphia, PA 19107-4824 | 2005-06-22 |
| 1265046569 | Sherman John Torres | Nurse Anesthetist, Certified Registered | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-09-03 |
| 1609489376 | Andrew Michael Mcguire | Registered Nurse | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-08-24 |
| 1326657420 | Daniel Joseph Leehan | Pharmacist | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-07-24 |
| 1013539436 | Kashyap Rajendra Chauhan | Internal Medicine | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-05-07 |
| 1134749385 | Maria Mattioli | Nurse Practitioner | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-04-17 |
| 1598392151 | Amine Sahmoud | Student in an Organized Health Care Education/Training Program | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-03-24 |
| 1346877198 | Abigail M O'connell | Nurse Practitioner | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-03-23 |
| 1396370342 | Alexandra Elder | Student in an Organized Health Care Education/Training Program | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-03-10 |
| 1134754252 | Christopher James Neely | Student in an Organized Health Care Education/Training Program | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496575 | Albert Abbo | Nurse Practitioner | 801 Spruce St Fl 3, Philadelphia, PA 19107-5701 | 2020-10-30 |
| 1902411721 | Sean Arthur Deiter | Nurse Practitioner | 3619 Gypsy Ln, Philadelphia, PA 19129-1612 | 2020-09-09 |
| 1972117687 | Christopher Brian Cox | Nurse Practitioner | 4527 Kingsessing Ave Fl 1, Philadelphia, PA 19143-3712 | 2020-09-01 |
| 1053949081 | Anna Sorci | Nurse Practitioner | 5401 Old York Rd # Klein300, Philadelphia, PA 19141-3030 | 2020-03-27 |
| 1629611488 | Shane M Hafer | Nurse Practitioner | 3600 Civic Center Blvd Fl 3, Philadelphia, PA 19104-4310 | 2019-10-24 |
| 1184272262 | Judy Linh | Nurse Practitioner | 901 Glenview St, Philadelphia, PA 19111-4420 | 2019-08-31 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1942777909 | Jessica Lynn Goins | Nurse Practitioner | 111 S 11th St Bldg 934, Philadelphia, PA 19107-4824 | 2018-10-29 |
| 1891201968 | Stefanie Rashti | Nurse Practitioner | 1015 Walnut St Ste 401, Philadelphia, PA 19107-5005 | 2017-12-27 |
| 1780074336 | Bridget Gibson | Nurse Practitioner | 1522 E Susquehanna Ave, Philadelphia, PA 19125-2921 | 2015-02-03 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
Please comment or provide details below to improve the information on JENNIFER COSTELLO.
| 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.