AUDRA COSTON (NPI# 1962012146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962012146 |
Entity Type | Individual |
Full Name | AUDRA COSTON |
Credential | PMHNP |
Practice Address |
1171 107th St Grand Prairie TX 75050-2502 |
Practice Telephone | 9725970843 |
Mailing Telephone | 9725970843 |
Enumeration Date | 2020-08-03 |
Last Update Date | 2020-11-03 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP146041 | TX | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1171 107TH ST |
City | GRAND PRAIRIE |
State | TX |
Zip Code | 75050-2502 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750536462 | Angelica Torres Yrigollen | Nurse Practitioner | 1171 107th St, Grand Prairie, TX 75050-2502 | 2008-11-21 |
1639562093 | Monique Fincannon | Nurse Practitioner | 1171 107th St, Grand Prairie, TX 75050-2502 | 2015-03-10 |
1871850750 | Grand Prairie Professional Group, P. A. | Psychiatry & Neurology | 1171 107th St, Grand Prairie, TX 75050-2502 | 2012-04-18 |
1063786069 | Greenhouse Treatment Center, LLC | Clinic/Center | 1171 107th St, Grand Prairie, TX 75050 | 2012-03-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225539695 | Christopher Bachman | Physical Therapy Assistant | 2045 Hwy 360, #100b, Grand Prarie, TX 75050 | 2018-02-21 |
1003335233 | L & B Group Home LLC | In Home Supportive Care | 605 E Palace Pkwy Ste, B4, Grand Prairie, TX 75050 | 2017-09-19 |
1073054748 | Smileeasy Dental Grand Prairie, Pllc | Dentist | 2650 S Hwy 161, Grand Prairie, TX 75050 | 2017-03-15 |
1164966651 | Prime Diagnostic Imaging of Irving, LLC | Clinic/Center | 2210 Paddock Way, Grand Prairie, TX 75050 | 2016-12-19 |
1366801037 | Monica Simpson | Counselor | 2080 N Hwy 360, Ste 430, Grand Prairie, TX 75050 | 2016-02-23 |
1437545845 | Stateserv Medical of Texas | Durable Medical Equipment & Medical Supplies | 1000 Post and Paddock Street, #305, Grand Prairie, TX 75050 | 2015-04-13 |
1912304593 | Tenishia Chintankwa | Non-emergency Medical Transport (VAN) | 2403 Doreen St, Grand Prairie, TX 75050 | 2014-11-26 |
1780023192 | Holland Surgical Group | Physician Assistant | 201 West Tarrant Rd. #1420, Grand Prairie, TX 75050 | 2013-06-19 |
1174962823 | Occumed Plus-grand Prairie | General Practice | 805 W. North Carrier Pkwy, 260, Grand Prairie, TX 75050 | 2013-06-17 |
1497099618 | Sorai Susanne S Stuart | Counselor | 2825 N. State Hwy 360, 710, Grand Prairie, TX 75050 | 2012-11-15 |
Find all providers in zip 75050 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669098356 | Doris Cudjoe | Nurse Practitioner | 2436 Silverado Trl, Grand Prairie, TX 75052-8622 | 2020-06-18 |
1467081398 | Psy-clarity Mental Health | Nurse Practitioner | 647 Delores Dr, Grand Prairie, TX 75052-4850 | 2020-04-03 |
1194357780 | Catherine Kwarteng Nyarko | Nurse Practitioner | 2931 Montalbo, Grand Prairie, TX 75054-6507 | 2020-02-11 |
1497385645 | Babatunde Shittu | Nurse Practitioner | 3036 Larreta, Grand Prairie, TX 75054-6794 | 2020-01-16 |
1477193084 | Olayinka Ajofoyinbo | Nurse Practitioner | 3007 Summerview Dr, Grand Prairie, TX 75052-0446 | 2020-01-11 |
1063059756 | Modupe Olatunde | Nurse Practitioner | 6039 Cedar Glen Dr, Grand Prairie, TX 75052-0409 | 2019-12-02 |
1184276503 | Elizabeth Ogbonna | Nurse Practitioner | 3090 Outlet Pkwy Apt 220, Grand Prairie, TX 75052-7242 | 2019-07-15 |
1942860259 | Comfort Pokoo | Nurse Practitioner | 2128 Hacienda Ct, Grand Prairie, TX 75052-8844 | 2019-06-18 |
1780192666 | Nkechi F Ezema | Nurse Practitioner | 1075 Wood Stream Dr, Grand Prairie, TX 75052-8838 | 2018-01-13 |
1841701323 | Elo Edith Omakor | Nurse Practitioner | 3507 Tamarack Dr, Grand Prairie, TX 75052-7860 | 2017-10-24 |
Find all providers in GRAND PRAIRIE |
City | GRAND PRAIRIE |
Zip Code | 75050 |
Please comment or provide details below to improve the information on AUDRA COSTON.
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.