Individual
MR. ADAM RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2806 N SPEER BLVD, DENVER, CO 80211
(720) 457-5642
(720) 457-5642
Mailing address
90 MADISON ST, SUITE 308, DENVER, CO 80206-5418
(720) 457-5642
(720) 457-5642
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP-990117
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06122388
—
CO
Enumeration date
07/05/2010
Last updated
06/04/2018
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