Individual provider · Type 1 NPI
Jennifer Russo, RN, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Las Vegas, NV
NPI number
1407200413
Active
Practice location
2480 E Tompkins Ave Ste 100
Las Vegas, NV 89121-7394
Fax (877) 418-8013
Mailing address
83 Kind Ave
Henderson, NV 89002-3364
Other practice locations
- 83 Kind Ave, Henderson, NV 89002-3364 · (702) 824-7691
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Health Educator | 174H00000X | RN55131 (NV) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | G167246 (IA) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 238538 (AZ) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 848206 (NV) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 202203390-NP-PP (OR) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1407200413
Jennifer Russo, RN, PMHNP's National Provider Identifier is 1407200413, issued on Apr 15, 2016. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Las Vegas, NV. The record was last updated on Oct 31, 2024.