Individual
DANIELLE RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1495 NE 3RD ST, STE. C, PRINEVILLE, OR 97754-2905
(541) 447-4511
Mailing address
PO BOX 2126, TERREBONNE, OR 97760-2126
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
—
OR
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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