Provider Demographics
NPI:1912648866
Name:RUSSO, ANGELA FRANCES (RN BSN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:FRANCES
Last Name:RUSSO
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-1805
Mailing Address - Country:US
Mailing Address - Phone:513-253-2337
Mailing Address - Fax:
Practice Address - Street 1:771 GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-1805
Practice Address - Country:US
Practice Address - Phone:513-253-2337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.338438163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty