Individual
EBONEY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 ROBINWOOD BLVD, AKRON, OH 44312-1325
(330) 777-9020
Mailing address
118 ROBINWOOD BLVD, AKRON, OH 44312-1325
(330) 777-9020
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400863800209
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164817
—
OH
Enumeration date
04/19/2017
Last updated
04/19/2017
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