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Individual
DAWN MARIE RUSSO
Active
Individual
DAWN MARIE RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
413287
NY
363LF0000X
Family Nurse Practitioner
Primary
11014872
FL
363LF0000X
Family Nurse Practitioner
F332165
NY
Other
Enumeration date
03/30/2007
Last updated
11/23/2021
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