Provider Demographics
NPI:1134112857
Name:COSTELLO, JANET BRAIDWOOD (MS, CFNP)
Entity Type:Individual
Prefix:MRS
First Name:JANET BRAIDWOOD
Middle Name:
Last Name:COSTELLO
Suffix:
Gender:F
Credentials:MS, CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 DRUID HL
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-2413
Mailing Address - Country:US
Mailing Address - Phone:540-635-2300
Mailing Address - Fax:540-678-0795
Practice Address - Street 1:1847 W PLAZA DR
Practice Address - Street 2:APPLE BLOSSOM FAMILY PRACTICE
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6365
Practice Address - Country:US
Practice Address - Phone:540-678-0792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024087875363LF0000X
VA0001087875363LF0000X
VA0017001440363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAMC0939328OtherDEA NUMBER
VAS56439Medicare UPIN