Individual
NICKI LEE RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11 HILLTOP PLZ, KITTANNING, PA 16201-8905
(724) 545-8420
Mailing address
1374 N GRANT AVE, KITTANNING, PA 16201-1052
(724) 954-5203
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN642111
PA
Other
Enumeration date
02/14/2019
Last updated
02/14/2019
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