Individual
JACQUELYN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
1855 4TH ST, SAN FRANCISCO, SAN FRANCISCO, CA 94158
(978) 808-6646
Mailing address
60 SYCAMORE ST APT A, SAN FRANCISCO, CA 94110-1222
(978) 808-6646
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
NP95015822
CA
Other
Enumeration date
03/12/2021
Last updated
03/12/2021
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