Provider Demographics
NPI:1659997971
Name:COSTA, JESSICA H (DNP,FNP-C, PMHNP-C)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:H
Last Name:COSTA
Suffix:
Gender:F
Credentials:DNP,FNP-C, PMHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 ROUTE 70 E STE 3
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1769
Mailing Address - Country:US
Mailing Address - Phone:908-782-1300
Mailing Address - Fax:908-548-9544
Practice Address - Street 1:3000 ATRIUM WAY STE 200
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3910
Practice Address - Country:US
Practice Address - Phone:908-782-1300
Practice Address - Fax:908-548-9544
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01038800363LF0000X, 363LP0808X
PASP022363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily