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Individual
GINA M. RUSSANO
Active
Individual
GINA M. RUSSANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-CNM
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041195067
IL
367A00000X
Advanced Practice Midwife
Primary
209-003034
IL
Other
Enumeration date
05/12/2006
Last updated
03/02/2020
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