Costello, Kristine M

Costello, Kristine M is an individual health care provider with primary practice located at 5520 Godfrey Rd Ste B , Godfrey IL 62035-2741. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Costello, Kristine M can be contacted via phone (618) 463-7800.

Contact Information

Primary practice address
5520 Godfrey Rd Ste B Godfrey IL 62035-2741
Phone: (618) 463-7800
Fax: (618) 467-0073
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 2016000994 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209013674 Illinois

Profile Details

NPI number 1922469402
LBN Legal business name Costello, Kristine M
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 11th, 2016
Last updated Feb 26th, 2021 - about 5 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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