Individual
AUDREY RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1252 VIRGIL LANGFORD RD FL 2, WATKINSVILLE, GA 30677-7245
(770) 312-7594
Mailing address
1041 FOX GLEN DR, WATKINSVILLE, GA 30677-1502
(770) 312-7594
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN215319
GA
Other
Enumeration date
10/20/2017
Last updated
05/06/2022
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