Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
PHYLLIS JUNE RUSSO, MSN, ARNP, GCNS-BC
Active Sole ProprietorPHYLLIS JUNE RUSSO, MSN, ARNP, GCNS-BC is a Gerontological Nurse Practitioner healthcare provider located in BONITA SPRINGS, Florida. NPI 1932108586 is currently active in the NPPES registry. Verify at CMS.
Gerontological Nurse Practitioner · BONITA SPRINGS, FL
Registration Details
- NPI Number
- 1932108586
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 16, 2005 (20.895428532884 yrs)
- Last Updated
- Dec 9, 2009
- Licenses
-
ARNP 2128402 (FL)0134457-18 (CT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3368 WOODS EDGE CIRSUITE 104BONITA SPRINGS, FL, 341343437Browse FL providers · Browse ZIP 34134
- Phone
- 2394955315
- Fax
- 2395961709
- Primary Specialty
-
Gerontological Nurse Practitioner
363LG0600X
- Additional Specialty
- Gerontological Clinical Nurse Specialist
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.