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Individual
LESLIE LARAE RUSSELL-BROCKETT
Active
Individual
LESLIE LARAE RUSSELL-BROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
661273
TX
363LA2100X
Acute Care Nurse Practitioner
661273
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP114563
TX
Other
Enumeration date
07/27/2006
Last updated
12/23/2021
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