Individual provider · Type 1 NPI
Kathryn D. Russo, N.P.
Family Nurse Practitioner · Boston, MA
NPI number
1124299631
Active
Practice location
147 Milk St, Provider Enrollment Dept. - 9th Floor
Boston, MA 02109-4806
Fax (617) 421-3487
Mailing address
133 Brookline Ave
Boston, MA 02215-3904
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 239289 (MA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1124299631
Kathryn D. Russo, N.P.'s National Provider Identifier is 1124299631, issued on Mar 13, 2008. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Boston, MA. The record was last updated on Mar 13, 2008.