Individual
SHIRLEY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
66 BARIBEAU DR, SUITE 9, BRUNSWICK, ME 04011-3230
(207) 373-6923
(207) 373-6959
Mailing address
66 BARIBEAU DR, SUITE 9, BRUNSWICK, ME 04011-3230
(207) 373-6923
(207) 373-6959
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
R024021
ME
Other
Enumeration date
03/11/2008
Last updated
03/11/2008
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