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NPI Code Detail

MEDICARE: JENNIFER COSTA FNP-BC

MEDICARE: JENNIFER COSTA 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 PractitionerAPRN-4899HI

General Provider Information

NPI Number : 1407670755
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER COSTA FNP-BC
Provider Business Mailing Address
First Line : PO BOX 893653
Second Line :
City : MILILANI
State : HI
Zip : 96789-0653
Country : US
Telephone Number : 512-215-3337
Fax Number :
Provider Business Practice Location Address
First Line : 3288 MOANALUA RD
Second Line :
City : HONOLULU
State : HI
Zip : 96819-1469
Country : US
Telephone Number : 808-432-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2024
Last Update Date : 01/24/2026

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Directions to “ JENNIFER COSTA FNP-BC” Practice Location

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