Provider Demographics
NPI:1346583994
Name:RUSSO, CHRISTINE ELLEN (BS RN-BC CARN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ELLEN
Last Name:RUSSO
Suffix:
Gender:F
Credentials:BS RN-BC CARN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 BLACKWATER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-4613
Mailing Address - Country:US
Mailing Address - Phone:603-335-3808
Mailing Address - Fax:
Practice Address - Street 1:25 OLD DOVER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3464
Practice Address - Country:US
Practice Address - Phone:603-516-9300
Practice Address - Fax:603-335-9278
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH011341-21163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse