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Individual

DIANNA RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1007 10TH AVE W, PALMETTO, FL 34221-3723
(912) 201-8000
Mailing address
1007 10TH AVE W, PALMETTO, FL 34221-3723
(912) 201-8000

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9570998
FL
363L00000X
Nurse Practitioner
Primary
APRN11046487
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
FL

Other

Enumeration date
03/10/2026
Last updated
04/01/2026
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