Provider Demographics
NPI:1154580975
Name:COSTA, ROSEMARY (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:
Last Name:COSTA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 APPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01022-1125
Mailing Address - Country:US
Mailing Address - Phone:413-593-3391
Mailing Address - Fax:
Practice Address - Street 1:165 APPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01022-1125
Practice Address - Country:US
Practice Address - Phone:413-593-3391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA151508163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse