Individual provider · Type 1 NPI

Raquel K. Russo, PA-C

Physician Assistant · Chesterfield, MO

NPI number 1013545607 Active

Practice location

13353 Olive Blvd
Chesterfield, MO 63017-3108

Call (636) 778-2900 Map

Fax (636) 778-2828

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X2022005794 (MO)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1013545607

Raquel K. Russo, PA-C's National Provider Identifier is 1013545607, issued on Mar 30, 2020. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Chesterfield, MO. The record was last updated on Nov 17, 2025.