Individual
STUART RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2330 E JASMINE ST, MESA, AZ 85213-2922
(480) 980-7302
Mailing address
2330 E JASMINE ST, MESA, AZ 85213-2922
(480) 980-7302
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA1397
AZ
Other
Enumeration date
05/01/2017
Last updated
05/01/2017
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