MACKENZIE COSTELLO


Address: 1630 Main St Ste 101, Chester, MD 21619-2792
Phone: 4106046560

MACKENZIE COSTELLO (NPI# 1548797376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548797376
Entity Type Individual
Full Name MACKENZIE COSTELLO
Other Name MACKENZIE SCOFIELD
Credential CRNP
Practice Address 1630 Main St Ste 101
Chester
MD 21619-2792
Practice Telephone 4106046560
Practice Fax Number 4106435789
Mailing Telephone 4106046560
Mailing Fax Number 4106435789
Enumeration Date 2017-05-11
Last Update Date 2020-08-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse RN1033652 DC Nursing Service Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
R227450 MD Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1630 MAIN ST STE 101
City CHESTER
State MD
Zip Code 21619-2792

Providers in the same location

NPI Name Taxonomy Address Enumeration
1861050619 Orthopedic Physicians of Annapolis LLC Orthopaedic Surgery 1630 Main St Ste 101, Chester, MD 21619-2792 2019-06-05
1902375512 Valerie Elizabeth Wallace Registered Nurse 1630 Main St Ste 101, Chester, MD 21619-2792 2018-11-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1407359532 Queen Anne's Medical Center, LLC Internal Medicine 2108 Rear Didonato Drive, Chester, MD 21619 2018-03-15
1700326410 Erika Waynik Nurse Practitioner 115 South Piney Road, Minuteclinic, Chester, MD 21619 2017-02-28
1780923425 Sabitri Baker Specialist 210 Country Day Rd, Chester, MD 21619 2013-01-31
1487986287 Richard Davis Brown Family Medicine 128 Kirwans Landing Ln, Chester, MD 21619 2010-02-03
1225299837 Kent Island Chiropractic and Rehabilitation Clinic/Center 1812 Main St., Suite C, Chester, MD 21619 2008-06-17
1407048283 Brian Johnson Olmstead Dentist 1547 Rainbow Plaza, Chester, MD 21619 2007-08-15
1972721165 John A Benkovich IIi Dentist 800 Abruzzi Drive Unit F, Chester, MD 21619 2007-04-23
1457400798 James Charles Pochron Dentist 116 South Piney Rd #202, Chester, MD 21619 2007-01-09
1578628608 Kent Drug Inc Pharmacy 1723 Main St, Chester, MD 21619 2006-12-27
1750304275 Lisa Rene' Jackson-cherry Counselor 1114 Didinato Dr, Chester Regional Medical Center, Chester, MD 21619 2006-07-25
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1427659010 Angela Marie Baker Nurse Practitioner 12631 Harrowgate Rd, Chester, VA 23831-4808 2020-11-02
1730704727 Shiloh Campbell Nurse Practitioner 63 Mulberry Ln, Chester, WV 26034-2150 2020-06-15
1225665011 Lisa Dawn Gastan Nurse Practitioner 1 Medical Center Blvd Ste 336, Chester, PA 19013-3902 2020-03-24
1346802857 Felecia Macklin Copeland Nurse Practitioner 11601 Iron Bridge Rd Ste 201, Chester, VA 23831-1468 2019-07-04
1619435534 Alysha Mcfarlin Nurse Practitioner 13435 Green Orchard Ct, Chester, VA 23836-7905 2019-03-10
1306314414 Trina Harris Nurse Practitioner 4807 Glenmorgan Ct, Chester, VA 23831-6596 2018-11-06
1821599473 Lynn Carol Davis Nurse Practitioner 103 Cestrain Sq, Chester, SC 29706-1979 2018-02-27
1700326410 Erika Waynik Nurse Practitioner 115 South Piney Road, Minuteclinic, Chester, MD 21619 2017-02-28
1831638923 Sabrina Shanay Hughes Nurse Practitioner 13613 Greyfield Dr, Chester, VA 23831-6785 2017-02-22
1891101689 Timothy R Blair Sr. Nurse Practitioner 418 West Madison, Liberty Medical Center Clinic, Chester, MT 59522 2014-07-01
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Competitor

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City CHESTER
Zip Code 21619

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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