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General NPI Number Information
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NPI Number | 1952881229
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Entity Type | Individual
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Provider Name | AMANDA RUSSO APRN NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/16/2018
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 18450 HIGHWAY 59 N
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City | HUMBLE
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State | TX
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Zip | 77338-4404
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Country | US
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Telephone | 281-446-6656
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Fax | 281-446-6657
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Provider Business Mailing Address
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Address Line | 18450 HIGHWAY 59 N
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City | HUMBLE
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State | TX
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Zip | 77338-4404
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Country | US
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Telephone | 281-446-6656
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1072466
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1072466
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License Number State | TX
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