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Individual

AMANDA RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
314 GROVE NECK RD, EARLEVILLE, MD 21919-3008
(410) 275-6200
Mailing address
314 GROVE NECK RD, EARLEVILLE, MD 21919-3008

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
L1-0049815
DE

Other

Enumeration date
09/12/2023
Last updated
09/12/2023
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