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NPI Code Detail

MEDICARE: MS. LAUREN BRYANT RUSSO APRN

MEDICARE:  MS. LAUREN BRYANT RUSSO  APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse409369OH
2363LF0000XFamily Nurse Practitioner023857OH

General Provider Information

NPI Number : 1164991949
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAUREN BRYANT RUSSO APRN
Provider Business Mailing Address
First Line : 2780 AIRPORT DR STE 100
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-2289
Country : US
Telephone Number : 614-859-1906
Fax Number : 614-645-5517
Provider Business Practice Location Address
First Line : 3781 S HIGH ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-4011
Country : US
Telephone Number : 614-645-3163
Fax Number : 614-645-5893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2018
Last Update Date : 11/21/2018

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Directions to “ MS. LAUREN BRYANT RUSSO APRN” Practice Location

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