Individual
MRS. GEORGIA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
450 WILLIAMS WAY, MOAB, UT 84532
(435) 719-3510
(435) 719-3509
Mailing address
450 WILLIAMS WAY, MOAB, UT 84532-2185
(435) 719-3510
(435) 719-3509
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209410-4405
UT
Other
Enumeration date
03/26/2008
Last updated
08/16/2018
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