Individual
MRS. DANYA LEE RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
500 OSBORN BLVD, SAULT SAINTE MARIE, MI 49783-1822
(906) 635-4460
(906) 635-4460
Mailing address
3330 SUN GLO DR, SAULT SAINTE MARIE, MI 49783-9042
(906) 322-3246
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704273908
MI
363LF0000X
Family Nurse Practitioner
Primary
4704273908
MI
Other
Enumeration date
01/27/2017
Last updated
07/21/2022
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