KELLY L COSTELLO


Address: 2450 Riverside Ave, Minneapolis, MN 55454-1450
Phone: 6122730069

KELLY L COSTELLO (NPI# 1588858039) 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) 1588858039
Entity Type Individual
Full Name KELLY L COSTELLO
Other Name KELLY L MCCORMICK
Credential RD
Practice Address 2450 Riverside Ave
Minneapolis
MN 55454-1450
Mailing Address 6041 4th Ave S
Minneapolis
MN 55419-2510
Practice Telephone 6122730069
Mailing Telephone 6129109579
Enumeration Date 2007-08-28
Last Update Date 2012-11-30
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 133VN1004X Dietitian, Registered
Specialization: Nutrition, Pediatric 		1690 MN Dietary & Nutritional Service Providers

Other Providers KELLY COSTELLO

NPI Name Taxonomy Address Enumeration
1194177949 Kelly Lynn Costello Behavioral Analyst 4103 Lester Ct, Alexandria, VA 22311-1121 2016-07-05
1295192268 Kelly Costello Developmental Therapist 1501 Frost Rd, Mechanicsburg, PA 17055-5134 2016-01-21
1659507226 Kelly N Costello Occupational Therapist 4622 40th Ave S Ste B, Fargo, ND 58104-4394 2009-06-09
1194237495 Kelly Marie Costello Pharmacist 1200 W Fayette Ave, Effingham, IL 62401-1913 2017-10-26
1497159412 Kelly Costello Counselor 1714 Jarrettsville Rd, Jarrettsville, MD 21084-1524 2014-10-20
1780011932 Kelly Costello Social Worker 2500 18th St, San Francisco, CA 94110-2109 2013-10-02
1639389448 Kelly E Costello Counselor 95 Pleasant St, Lynn, MA 01901-1524 2007-05-23
1801828884 Kelly L Costello Pediatrics 401 N 17th St, Suite 203, Allentown, PA 18104-5034 2006-07-07

Office Location

Street Address 2450 RIVERSIDE AVE
City MINNEAPOLIS
State MN
Zip Code 55454-1450

Providers in the same location

NPI Name Taxonomy Address Enumeration
1568462570 Sreejaya Veluvali Psychiatry & Neurology 2450 Riverside Ave, Minneapolis, MN 55454-1450 2005-08-01
1588265375 Fairview Health Services General Acute Care Hospital 2450 Riverside Ave, Minneapolis, MN 55454-1450 2020-11-06
1215535927 Katrina Joelle Christian Student in an Organized Health Care Education/Training Program 2450 Riverside Ave, Department of Pediatrics, 6 East Building, Minneapolis, MN 55454-5510 2020-10-14
1023616208 Jodi Renee Nelson Psychologist 2450 Riverside Ave, Minneapolis, MN 55454-1450 2020-10-11
1912504150 Pamela Norling Counselor 2450 Riverside Ave, Minneapolis, MN 55454-1450 2020-10-01
1225635345 Trevor Ryan Goldsmith Nurse Anesthetist, Certified Registered 2450 Riverside Ave, Minneapolis, MN 55454-1450 2020-10-01
1215534342 Michelle L White Marriage & Family Therapist 2450 Riverside Ave, Attn: Adult Cd Lodging Plus, Minneapolis, MN 55454-1450 2020-10-01
1295341048 Tobias Zander Donlon Student in an Organized Health Care Education/Training Program 2450 Riverside Ave, Minneapolis, MN 55454-1450 2020-09-17
1417562497 Megan Farr Dietitian, Registered 2450 Riverside Ave, Minneapolis, MN 55454-1450 2020-09-15
1871101238 Fairview Express Care General Practice 2450 Riverside Ave, Minneapolis, MN 55454-1450 2020-07-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1194341842 Bruce Zhang Student in an Organized Health Care Education/Training Program 606 24th Ave. S. Suite 200, Minneapolis, MN 55454 2020-06-18
1205456738 Sara Segner Student in an Organized Health Care Education/Training Program Peds Education Office M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 2020-04-24
1417576844 Sabena Khan Student in an Organized Health Care Education/Training Program M136, 1st Floor, East Building. 2450 Riverside Avenue, Minneapolis, MN 55454 2020-04-15
1811525983 Kayla Joy Solstad Student in an Organized Health Care Education/Training Program M136, 1st Floor, East Bldg., 2450 Riverside Ave, Minneapolis, MN 55454 2020-04-01
1720647126 Lauren Harasymiw Student in an Organized Health Care Education/Training Program Pediatrics Ed. Office, M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 2019-06-10
1689237448 Katelyn Marie Adams Student in an Organized Health Care Education/Training Program Pediatrics Education Office, M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 2019-04-17
1285197848 Adrienne Bruder Student in an Organized Health Care Education/Training Program M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 2019-04-10
1588142855 Stewart Graeme Morrison Student in an Organized Health Care Education/Training Program Department of Orthopaedics University of Minnesota, 2450 Riverside Ave R200, Minneapolis, MN 55454 2018-07-30
1831682251 Sherab Tsheringla Student in an Organized Health Care Education/Training Program 2450 Riverside Avenue South, Minneapolis, MN 55454 2018-06-11
1669962148 Pooja Elizabeth Mishra Student in an Organized Health Care Education/Training Program M136, 1st Floor, East Building 8950a (campus Delivery C, 2450 Riverside Ave, Minneapolis, MN 55454 2018-05-10
Find all providers in zip 55454

Taxonomy Information

Taxonomy Code 133VN1004X
Grouping Dietary & Nutritional Service Providers
Classification Dietitian, Registered
Specialization Nutrition, Pediatric

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1417562497 Megan Farr Dietitian, Registered 2450 Riverside Ave, Minneapolis, MN 55454-1450 2020-09-15
1275821761 Laura Gearman Dietitian, Registered 2450 Riverside Ave, Minneapolis, MN 55454-1450 2011-07-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1407139868 Rachel Fog Dietitian, Registered 14500 99th Ave N, Maple Grove, MN 55369-4730 2011-09-22

Competitor

Search similar providers

City MINNEAPOLIS
Zip Code 55454

Improve Information

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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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