Individual
MRS. KELLY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
18 IMPERIAL PL UNIT 2D, PROVIDENCE, RI 02903-4642
(401) 727-4800
(401) 921-4800
Mailing address
101 DUDLEY ST, PROVIDENCE, RI 02905-2401
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
—
—
Other
Enumeration date
03/16/2020
Last updated
07/19/2024
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