Provider Demographics
NPI:1467901462
Name:LARUSSO, ALLISON JEAN (RN)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:JEAN
Last Name:LARUSSO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23157 HUFF RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:DE
Mailing Address - Zip Code:19968-2546
Mailing Address - Country:US
Mailing Address - Phone:302-233-5991
Mailing Address - Fax:
Practice Address - Street 1:23157 HUFF RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:DE
Practice Address - Zip Code:19968-2546
Practice Address - Country:US
Practice Address - Phone:302-233-5991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-02
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0041463163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse