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General NPI Number Information
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NPI Number | 1689374134
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Entity Type | Individual
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Provider Name | ERICA DOSTIE RUSSO-ALESI FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/03/2023
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 5470 MARTHA BERRY HWY NE
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City | ARMUCHEE
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State | GA
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Zip | 30105-2302
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Country | US
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Telephone | 762-235-3830
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Fax | 706-291-9391
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Provider Business Mailing Address
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Address Line | 221 TECHNOLOGY PKWY NW
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City | ROME
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State | GA
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Zip | 30165-1369
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Country | US
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Telephone | 762-235-1000
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN258303
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License Number State | GA
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