Individual
SHANA M RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
196 NORTH ST, GENEVA, NY 14456-1651
(315) 787-4500
Mailing address
196 NORTH ST, GENEVA, NY 14456-1651
(315) 787-4500
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
336385
NY
Other
Enumeration date
07/13/2010
Last updated
07/13/2010
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