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NPI Code Detail

MEDICARE: CATHERINE G COSTANTINO FNP-BC

MEDICARE: CATHERINE G COSTANTINO FNP-BC
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
1363LF0000XFamily Nurse PractitionerR194240MD

General Provider Information

NPI Number : 1942977673
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE G COSTANTINO FNP-BC
Provider Business Mailing Address
First Line : 11100 BILLINGSLEY RD
Second Line :
City : WALDORF
State : MD
Zip : 20602-3400
Country : US
Telephone Number : 240-754-6123
Fax Number :
Provider Business Practice Location Address
First Line : 11100 BILLINGSLEY RD
Second Line :
City : WALDORF
State : MD
Zip : 20602-3400
Country : US
Telephone Number : 240-754-6123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2021
Last Update Date : 08/30/2021

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