Marissa Russo, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F01210887 Issued in NC

Practice address

8712 Lindholm Dr Ste 302
Huntersville, NC 28078-1872

Phone

(704) 997-6530

NPI assigned

Jan 28, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1558952911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13809 HILL ST",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785328",
            "telephone_number": "315-546-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8712 LINDHOLM DR STE 302",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280781872",
            "telephone_number": "704-997-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "MARISSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "F01210887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyla Ruffin-Hill, LCSW-A
• Christian Ruiz, PHARMD
• Jessica Runnion
• Stephanie Rush, SLP ASSISTANT
• Megan Katherine Russell
• Steven Christopher Russo, PA-C
• Jennifer Rutalis
• Allyson Torrence Rutledge, RD LDN
• Caroline Ryan
• Carrisa J Ryan, M.A. , LPC

• Nurse Practitioner in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.