Individual
LYNN ANN NELSON RUSSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC,MSN,CRNP
Contact information
Practice address
WIDENER UNIVERSITY STUDENT HEALTH SERVICES, ONE UNIVERSITY PLACE, CHESTER, PA 19013
(610) 499-1183
Mailing address
7921 WESTVIEW AVE, UPPER DARBY, PA 19082-2810
(610) 449-0711
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
UP000904C
PA
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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