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1487331955
JENNIFER RUSSO
LAFAYETTE, LA
NPI
1487331955
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: LA 231237)
Enumeration Date
2023-06-28
Last Update Date
2023-06-28
Business Address
JENNIFER RUSSO PMHNP
406 SAINT JULIEN AVE
LAFAYETTE, LA 70506-4622
Phone number: 337-366-6050
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Mailing Address
JENNIFER RUSSO PMHNP
1045 JOE MOUTON RD
SAINT MARTINVILLE, LA 70582-6225
Phone number: 337-278-3151
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