MRS. ELLEN SUSAN RUSSO (NPI# 1003059106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003059106 |
| Entity Type | Individual |
| Full Name | MRS. ELLEN SUSAN RUSSO |
| Credential | APRN,BC |
| Practice Address |
Circle Drive Building 5h Perry Point MD 21902 |
| Practice Telephone | 4106422411 |
| Mailing Telephone | 4106422411 |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2009-04-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
R046307 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
CIRCLE DRIVE BUILDING 5H |
| City | PERRY POINT |
| State | MD |
| Zip Code | 21902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245321983 | Carolina Cruz Custodio | Internal Medicine | Circle Drive, Va Maryland Health Care Systems, Perry Point, MD 21902 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699373159 | Daniel Vigus | Recreation Therapist | 59 Ave D, Perry Point, MD 21902 | 2020-10-15 |
| 1407471758 | Amanda Dawn Morris | Optometrist | Perry Point Va Medical Center - Va Maryland Health Care, Perry Point, MD 21902 | 2020-06-12 |
| 1639672835 | Sarah Nicole Cassatt | Dietitian, Registered | Perry Point Va Medical Center Avenue D & 8th St, Perry Point, MD 21902 | 2018-03-14 |
| 1669981809 | Kristyn Sanders | Social Worker | Avenue D & 8th St., Perry Point, MD 21902 | 2017-09-20 |
| 1093250342 | Maria Elana Bergeron | Nurse Practitioner | Bldg 25 Perry Point Va Medical Center, Perry Point, MD 21902 | 2016-12-22 |
| 1124572037 | Jonathan Raymond | Physical Therapist | Avenue D & 8th St, Perry Point, MD 21902 | 2016-08-09 |
| 1528435732 | Stanley Prochaska Jr. | Nurse Practitioner | 1 Avenue D, Perryville, MD 21902 | 2015-08-24 |
| 1346665437 | Doreen Carole Rupp | Social Worker | Avenue D, Building 19h, 244, Perry Point, MD 21902 | 2014-02-26 |
| 1457604944 | Justin Colin Everson | Internal Medicine | Building 19h, Room 270, Perry Point Va Medical Center, Perry Point, MD 21902 | 2012-10-21 |
| 1104198779 | Ashley Abell Carroll | Social Worker | 2h Circle Drive, Perry Point Veterans Affairs Medical Center, Perry Point, MD 21902 | 2012-01-30 |
| Find all providers in zip 21902 | ||||
| Taxonomy Code | 364SP0809X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548797624 | Regina Kitterman Keefe | Clinical Nurse Specialist | 2911 Olney Sandy Spring Rd Ste C, Olney, MD 20832-3507 | 2017-05-19 |
| 1245668151 | Beatrice Flynn | Clinical Nurse Specialist | 7625 Maple Lawn Blvd Ste 145, Fulton, MD 20759-2565 | 2013-10-31 |
| 1972896090 | Jo Carney Deaton | Clinical Nurse Specialist | 22 Woodlawn Ave, Apt. A, Catonsville, MD 21228-3431 | 2011-05-23 |
| 1487955530 | Linda Lewis Dwyer | Clinical Nurse Specialist | 1210 Emerald Ridge Dr, Westminster, MD 21158-3643 | 2010-11-05 |
| 1649506387 | Cecilia Y Lau | Clinical Nurse Specialist | 604 S Frederick Ave, Suite 213, Gaithersburg, MD 20877-1282 | 2009-10-31 |
| 1871765313 | Maria Dias Raynal | Clinical Nurse Specialist | 5805 Springfield Dr, Bethesda, MD 20816-1235 | 2008-03-25 |
| 1164638086 | Kathryn Demarinis Capozzoli | Clinical Nurse Specialist | 4 Riggs Ave, Severna Park, MD 21146 | 2007-05-15 |
| 1679652663 | Ruth A Yates | Clinical Nurse Specialist | 515 Piccadilly Road, Towson, MD 21204-3716 | 2006-11-02 |
| 1063502466 | Kathleen Brooks Hurley | Clinical Nurse Specialist | 4509 Hornbeam Dr, Rockville, MD 20853-1416 | 2006-10-13 |
| 1548226749 | Alice S Jonas | Clinical Nurse Specialist | 2 Oakway Road, Lutherville, MD 21093 | 2006-04-25 |
| Find all providers with the same taxonomy | ||||
| City | PERRY POINT |
| Zip Code | 21902 |
Please comment or provide details below to improve the information on MRS. ELLEN SUSAN RUSSO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.