Individual
MS. SHELLY RAE RUSSEFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
105 N INDIAN MERIDIAN RD, PAULS VALLEY, OK 73075-9236
(405) 207-9800
(405) 207-9898
Mailing address
301 E SEMINOLE ST APT 2, WYNNEWOOD, OK 73098-5629
(405) 207-1116
(405) 665-1001
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0058066
OK
Other
Enumeration date
08/15/2014
Last updated
03/11/2024
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