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General NPI Number Information
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NPI Number | 1558701672
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Entity Type | Individual
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Provider Name | ALLISON G RUSSO DNP, PMHNP- BC
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Gender | Female
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Dates
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Enumeration Date | 07/03/2013
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 3009 EARLY BIRD DR
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City | HELENA
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State | MT
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Zip | 59601-5670
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Country | US
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Telephone | 406-389-5286
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Fax |
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Provider Business Mailing Address
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Address Line | 3009 EARLY BIRD DR
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City | HELENA
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State | MT
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Zip | 59601-5670
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Country | US
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Telephone | 406-389-5286
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NUR-RN-LIC 38936
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License Number State | MT
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