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Individual

MARISSA RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
8712 LINDHOLM DR STE 302, HUNTERSVILLE, NC 28078-1872
(704) 997-6530
Mailing address
13809 HILL ST, HUNTERSVILLE, NC 28078-5328
(315) 546-5184

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F01210887
NC

Other

Enumeration date
01/28/2021
Last updated
01/28/2021
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