Individual
JEANINE RUSSELL NORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1601 CENTER ST, 2N, MOBILE, AL 36604
(251) 434-3475
(251) 434-3985
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 434-3626
(251) 445-2464
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.1169
AL
Other
Enumeration date
11/07/2016
Last updated
07/06/2018
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