Individual
MR. JARROD DAUN RUSSELL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA,
Contact information
Practice address
1746 NE 19TH ST, OKLAHOMA CITY, OK 73111-1439
(405) 900-3905
Mailing address
1746 NE 19TH ST, OKLAHOMA CITY, OK 73111-1439
(405) 900-3905
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
37V975170419
OK
376K00000X
Nurse's Aide
Primary
37V975170419
OK
385H00000X
Respite Care
37V975170419
OK
Other
Enumeration date
04/12/2021
Last updated
01/19/2022
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