Individual
SUSAN MARIE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RNC
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1631
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0001
(602) 263-1200
(602) 263-1631
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
684472
CA
163WX0003X
Inpatient Obstetric Registered Nurse
Primary
RN125309
AZ
Other
Enumeration date
03/26/2009
Last updated
03/26/2009
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