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Individual

MRS. SAMARA DEVA RUSSELL

Active
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Individual

MRS. SAMARA DEVA RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, NP-C

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
004763
CT
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ0107800
NJ
363LG0600X
Gerontology Nurse Practitioner
CAPRN00529
RI
364SX0106X
Occupational Health Clinical Nurse Specialist
4763
CT

Other

Enumeration date
09/07/2011
Last updated
08/04/2021
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