Costa, Jennifer M

Costa, Jennifer M is an individual health care provider with primary practice located at 55 Lake Ave N Pediatric Hematology-Oncology, Worcester MA 01655-0002. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Costa, Jennifer M can be contacted via phone (508) 856-4225.

Contact Information

Primary practice address
55 Lake Ave N Pediatric Hematology-Oncology Worcester MA 01655-0002
Phone: (508) 856-4225
Fax: (774) 441-8057
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X RN253211 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN253211 Massachusetts

Profile Details

NPI number 1225246341
LBN Legal business name Costa, Jennifer M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 21st, 2007
Last updated Nov 10th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225246341 NPPES
Massachusetts MEDICAID 110074761A

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