Individual
MRS. ANNE MARIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1550 WILDWOOD DR, PLAIN, WI 53577-9644
(608) 546-9834
Mailing address
208 BLUE VIEW DR, MOUNT HOREB, WI 53572-1802
(608) 886-0288
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
30536-31
WI
Other
Enumeration date
05/07/2012
Last updated
05/07/2012
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