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Individual
MRS. TABITHA RUSSELL
Active
Individual
MRS. TABITHA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
RN0000158598
TN
363LF0000X
Family Nurse Practitioner
Primary
18341
TN
Other
Enumeration date
11/24/2008
Last updated
03/29/2016
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