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MS. BRYCE LAUREN RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
1 CHILDRENS PL, DIV PED HEMATOLOGY & ONC, SAINT LOUIS, MO 63110-1002
(314) 454-6018
(844) 621-4392
Mailing address
1 CHILDRENS PL, MSC 8515-87-1200, SAINT LOUIS, MO 63110-1002
(314) 454-6018
(844) 621-4392

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2019005207
MO
363LP2300X
Primary Care Nurse Practitioner
2019005207
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
420076824
MO
Enumeration date
08/20/2013
Last updated
11/15/2021
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