Provider Demographics
NPI:1316306376
Name:COSTELLO MCCONNELL, JANE (NP-C)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:
Last Name:COSTELLO MCCONNELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7963 SURREY DR
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-2454
Mailing Address - Country:US
Mailing Address - Phone:720-252-7824
Mailing Address - Fax:
Practice Address - Street 1:2535 S DOWNING ST
Practice Address - Street 2:STE 380
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5847
Practice Address - Country:US
Practice Address - Phone:303-778-5797
Practice Address - Fax:303-778-5205
Is Sole Proprietor?:No
Enumeration Date:2016-02-18
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0992207-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily