NPI 1619023322

Paula Petrullo Russo, PA

Practitioner Medical Physician Assistant Ranson, WV

Practice location

Address: 207 E 5th Ave, Ranson, WV 25438-1613
Phone: (304) 728-5051
Fax: (304) 728-9735
Mailing address: 6568 Flowing Springs Rd, Shenandoah Junction, WV 25442-4666

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence 00382 (WV)

Other Physician Assistant providers in West Virginia →

Registry record

NPI: 1619023322
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Jan 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.