Individual
ANTHONY MICHAEL RUSSO
Active
Individual
ANTHONY MICHAEL RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
4704317005
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
1750950275
MI
367500000X
Certified Registered Nurse Anesthetist
APRN11029309
FL
Other
Enumeration date
06/19/2021
Last updated
09/27/2024
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