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NPI Code Detail

MEDICARE: AMANDA RUSSO APRN NP-C

MEDICARE: AMANDA RUSSO APRN NP-C
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
1363LF0000XFamily Nurse Practitioner1072466TX
2163W00000XRegistered Nurse1072466TX

General Provider Information

NPI Number : 1952881229
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA RUSSO APRN NP-C
Provider Business Mailing Address
First Line : 18450 HIGHWAY 59 N
Second Line :
City : HUMBLE
State : TX
Zip : 77338-4404
Country : US
Telephone Number : 281-446-6656
Fax Number :
Provider Business Practice Location Address
First Line : 18450 HIGHWAY 59 N
Second Line :
City : HUMBLE
State : TX
Zip : 77338-4404
Country : US
Telephone Number : 281-446-6656
Fax Number : 281-446-6657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2018
Last Update Date : 03/10/2026

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Directions to “ AMANDA RUSSO APRN NP-C” Practice Location

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