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

Individual provider Physician Assistant · NPI 1902094584

Crystal L Russo, PA is a Physician Assistant in Bismarck, North Dakota. Licensed in North Dakota. Registered with an NPI since 2007.

Licensed in
ND
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

900 E Broadway Ave
Bismarck, ND 58501-4520 Not confirmed with CMS for 10 years — call before visiting
Phone: (701) 530-6500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PAC0582 (ND)

Record details

NPI number1902094584
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 9, 2007
Last updated in NPPESJuly 22, 2016

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