Russo, Phyllis June

Russo, Phyllis June is an sole proprietor health care provider with primary practice located at 3368 Woods Edge Cir Suite 104, Bonita Springs FL 34134-3437. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Russo, Phyllis June can be contacted via phone (239) 495-5315.

Contact Information

Primary practice address
3368 Woods Edge Cir Suite 104 Bonita Springs FL 34134-3437
Phone: (239) 495-5315
Fax: (239) 596-1709
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X ARNP 2128402 Florida
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 364SG0600X 0134457-18 Connecticut

Profile Details

NPI number 1932108586
LBN Legal business name Russo, Phyllis June
Credentials MSN, ARNP, GCNS-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 16th, 2005
Last updated Dec 9th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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