Keith Aniel Russworm JR., NP
NPI #1497263222 in Pine Bluff, Arkansas
Provider Information
- NPI Number
- 1497263222
- Entity Type
- Individual
- Name
- Keith Aniel Russworm JR., NP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner
- Credential
- NP
- Enumeration Date
- Jan 15, 2018
- Last Updated
- Jan 25, 2018
Practice Location
- Address
- 1600 W 40TH AVE
- City
- Pine Bluff
- State
- Arkansas
- ZIP Code
- 71603-6301
- Phone
- (870) 541-7100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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