Amanda Russell

NPI #1710254388 in La Vista, Nebraska

Provider Information

NPI Number: 1710254388
Entity Type: Individual
Name: Amanda Russell
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Nov 25, 2011
Last Updated: Nov 25, 2011

Practice Location

Address: 8380 HARRISON ST
City: La Vista
State: Nebraska
ZIP Code: 68128-2918
Phone: (402) 592-7990

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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