Individual
MS. AYANNA NICOLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3875 S WESTERN AVE, LOS ANGELES, CA 90062-1105
(323) 290-4356
(323) 293-3327
Mailing address
7391 9TH ST APT 6, BUENA PARK, CA 90621-2746
(310) 946-7979
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN167101
CA
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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