Jessica Russell

NPI #1396192258 in Waterford, Michigan

Provider Information

NPI Number
1396192258
Entity Type
Individual
Name
Jessica Russell
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Licensed Practical Nurse
Enumeration Date
May 20, 2016
Last Updated
May 20, 2016

Practice Location

Address
7712 LAKE RIDGE DR
ZIP Code
48327-4164
Phone
(248) 505-7204

Specialties & Taxonomy Codes

Specialty
Licensed Practical Nurse

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