Individual
ANDREA RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
655 7TH ST BLDG 700, ROBINS AFB, GA 31098-2227
(478) 327-7850
Mailing address
655 7TH ST BLDG 700, ROBINS AFB, GA 31098-2227
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
GA
Other
Enumeration date
10/23/2023
Last updated
01/15/2025
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