Individual
REBECCA LOUISE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C
Contact information
Practice address
538B PROVIDENCE RD, BROOKLYN, CT 06234-3413
(959) 269-0019
(959) 269-0016
Mailing address
PO BOX 40, SOUTHBRIDGE, MA 01550-0040
(508) 909-7799
(508) 764-2432
Taxonomy
Speciality
Code
Description
License number
State
163WU0100X
Urology Registered Nurse
88008
CT
363L00000X
Nurse Practitioner
Primary
5951
CT
363LF0000X
Family Nurse Practitioner
5951
CT
363LF0000X
Family Nurse Practitioner
RN252020
MA
Other
Enumeration date
10/17/2014
Last updated
04/10/2026
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