Jenifer Dalla Costa, LPN

Individual provider Active NPI Licensed Practical Nurse · Hyannis, MA

NPI 1831493774 · NPPES record last updated Jan 7, 2011

Key facts

NPI
1831493774
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LN86172 (MA)
Practice address
30 Elm Ave
Hyannis, MA 02601-5547
Phone
(508) 778-0300
Fax
(508) 778-0301
NPI assigned
Jan 7, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LN86172MAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Health Services, Inc. Past Accepting new patients
Harbor Health Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LN86172 MA Yes

Addresses

Primary practice location

30 Elm Ave
Hyannis, MA 02601-5547

Mailing address

1135 Morton St
Mattapan, MA 02126-2834
Phone (617) 533-2300

Other providers in Hyannis, MA

All providers in Hyannis, MA · Licensed Practical Nurse in Massachusetts

Sources for this page

Verify at the official NPI Registry.