Danya Lee Russo, FNP-C
Nurse Practitioner, Family in Sault Sainte Marie, MI. Individual provider (NPI-1).
NPI number1871030833
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1871030833
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Danya Lee Russo
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 27, 2017
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 4704273908 | MI | Yes |
| 163W00000X | Registered Nurse | 4704273908 | MI |
Practice location
500 Osborn BlvdSault Sainte Marie, MI 49783-1822
Phone 906-635-4460 · Fax 906-635-4460
Mailing address
3330 Sun Glo DrSault Sainte Marie, MI 49783-9042
Phone 906-322-3246
Other practice locations
1719 N M 129
Cedarville, MI 49719-9777
Cedarville, MI 49719-9777
Phone 906-322-3246
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