Antoinette Russell

NPI #1457743916 in Lakeside, Arizona

Provider Information

NPI Number: 1457743916
Entity Type: Individual
Name: Antoinette Russell
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Emergency Medical Technician, Paramedic
Enumeration Date: Feb 20, 2015
Last Updated: Feb 20, 2015

Practice Location

Address: 2922 W WHITE MOUNTAIN BLVD
City: Lakeside
State: Arizona
ZIP Code: 85929-6152
Phone: (928) 368-6112

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medical Technician, Paramedic	146L00000X	Primary
Emergency Medical Technician, Basic	146N00000X

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