Individual
MS. MARGUERITE M RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-0838
(410) 328-0509
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-0838
(410) 328-0509
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R142683
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044553300
—
MD
01
—
R142683
STATE LICENSE
MD
01
—
S062-0574
CAREFIRST BC/BS
MD
Enumeration date
02/13/2009
Last updated
08/31/2015
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