Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Marie Russo, MSN, RN, CCRN, CPNP

Individual provider Registered Nurse · NPI 1518859545

Nicole Marie Russo, MSN, RN, CCRN, CPNP is a Nurse Practitioner in Stony Brook, New York. Qualified in 2024, 2 years ago. Licensed in New York.

Years since qualifying
2
Licensed in
NY
In the registry since
2025
Specialties on file
2
What do these letters mean?
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.
CPNP — Certified Pediatric Nurse Practitioner
A nurse practitioner certified in paediatrics.

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Practice location Address checks out

Hsc T11-020
Stony Brook, NY 11794-0001
Phone: (516) 306-6989
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence 393742 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 776987 (NY)

Record details

NPI number1518859545
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSN , RN , CCRN , CPNP
Sole proprietorNo
NPI enumeratedJuly 15, 2025
Last updated in NPPESDecember 21, 2025
Certification dateDecember 21, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Stony Brook