ELLEN L LARUSSO

DAYTONA BEACH, FL
NPI1427263383
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: FL  9428863)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: NY  F335300-1)
363LF0000X Nurse Practitioner, Family
(Licence: NC  5009587)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2007-05-14
Last Update Date2018-12-20
Business Address
ELLEN L LARUSSO APRN
301 MEMORIAL MEDICAL PKWY
DAYTONA BEACH, FL 32117-5167
Phone number: 386-231-3615
Mailing Address
ELLEN L LARUSSO APRN
5220 BELFORT RD STE 103
JACKSONVILLE, FL 32256-6017
Phone number: 904-446-3424