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Individual

MS. JENNIFER RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
3333 CAPITAL MEDICAL BLVD, TALLAHASSEE, FL 32308-4415
(872) 231-3162
Mailing address
PO BOX 7410884, CHICAGO, IL 60674-0884
(702) 899-0595
(702) 977-1496

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9198441
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ARNP9198441
MEDICAL LICENSE
FL
Enumeration date
12/20/2012
Last updated
10/02/2025
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