MEDICARE: MRS. JANET BRAIDWOOD COSTELLO MS, CFNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024087875	VA
2	363LF0000X	Family Nurse Practitioner	0001087875	VA
3	363LF0000X	Family Nurse Practitioner	0017001440	VA

General Provider Information

NPI Number	:	1134112857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANET BRAIDWOOD COSTELLO MS, CFNP

Provider Business Mailing Address
First Line	:	327 DRUID HL
Second Line	:
City	:	FRONT ROYAL
State	:	VA
Zip	:	22630-2413
Country	:	US
Telephone Number	:	540-635-2300
Fax Number	:	540-678-0795

Provider Business Practice Location Address
First Line	:	1847 W PLAZA DR
Second Line	:	APPLE BLOSSOM FAMILY PRACTICE
City	:	WINCHESTER
State	:	VA
Zip	:	22601-6365
Country	:	US
Telephone Number	:	540-678-0792
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2005
Last Update Date	:	03/07/2023

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