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Individual

MS. RENAE ROSS RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N. R.N.F.A. CNOR

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
631327
TX
163WR0006X
Registered Nurse First Assistant
Primary
631327
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0036KE
BCBS
Enumeration date
08/01/2006
Last updated
06/04/2020
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