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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BRIANA RUSSOM, PA-C

Active

Medical Physician Assistant · ROCKFORD, IL

Registration Details

NPI Number
1558661702
Provider Type
Individual
Gender
Female
NPI Issued
Oct 21, 2010 (15.501558208601 yrs)
Last Updated
Feb 19, 2021
License
085003897 (IL)

Practice Information

Address
2473 MCFARLAND RD
ROCKFORD, IL, 61107
Browse IL providers · Browse ZIP 61107
Phone
7796969202
Primary Specialty
Medical Physician Assistant
363AM0700X

Other Medical Physician Assistant Providers in ROCKFORD, IL

Name Credential NPI
MS. KRISTIN N. RINDT MPAS, PA-C 1295722411
MARK VANANROOY PA 1578541470
SHANNON V. TAYLOR PA-C 1265412084
MR. ANDREW J MASTERSON PA-C 1710922695
TAMMY M KUCIA PA C 1164533097
LEIGH A. RUELO PA-C 1902969231
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.