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Individual

COLLEEN RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
5775 WAYZATA BLVD, SUITE 200, ST LOUIS PARK, MN 55416-1222
(952) 525-4511
(952) 525-1560
Mailing address
5775 WAYZATA BLVD, SUITE 200, ST LOUIS PARK, MN 55416-1222
(952) 525-4511
(952) 525-1560

Taxonomy

Speciality
Code
Description
License number
State
163WN0800X
Neuroscience Registered Nurse
Primary
123839-2
MN

Other

Enumeration date
11/13/2009
Last updated
11/13/2009
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