Audrey Russo, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN215319 Issued in GA

Practice address

1252 Virgil Langford Rd FL 2
Watkinsville, GA 30677-7245

Phone

(770) 312-7594

NPI assigned

Oct 20, 2017

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)

Enrolled

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1689185357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 FOX GLEN DR",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306771502",
            "telephone_number": "770-312-7594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 VIRGIL LANGFORD RD FL 2",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777245",
            "telephone_number": "770-312-7594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "AUDREY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN215319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne M Rosen, MD
• Erin Reeves Rosene, MS
• Anaiah Rucker, RBT
• Martha E Rumsey, LCSW
• Zachary Russell, ATC, LAT, CSCS, OTC
• Minou Rysiew, L.C.S.W.
• Pimchanok Saardphothong, RBT
• Aliya Safwan, MD
• David Mathis Sailors, MD
• Amelia Sale

• Family Nurse Practitioner in Watkinsville, GA
• Providers in Watkinsville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.