Individual provider · Type 1 NPI
Phyllis June Russo, MSN, ARNP, GCNS-BC
Gerontology Nurse Practitioner · Bonita Springs, FL
NPI number
1932108586
Active
Practice location
3368 Woods Edge Cir, Suite 104
Bonita Springs, FL 34134-3437
Fax (239) 596-1709
Mailing address
2675 Creek Ln, # 202
Naples, FL 34119-7992
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | ARNP 2128402 (FL) |
| Gerontology Clinical Nurse Specialist | 364SG0600X | 0134457-18 (CT) |
Gerontology Nurse Practitioner: Definition to come...
2 other providers at this address
About NPI 1932108586
Phyllis June Russo, MSN, ARNP, GCNS-BC's National Provider Identifier is 1932108586, issued on Jul 16, 2005. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Bonita Springs, FL. The record was last updated on Dec 9, 2009.