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Individual

NICKIE R RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1997 HIGHWAY 51 S, COVINGTON, TN 38019-3630
(901) 476-8967
Mailing address
1997 HIGHWAY 51 S, COVINGTON, TN 38019-3630
(901) 476-8967

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0000068330
TN

Other

Enumeration date
03/27/2008
Last updated
03/27/2008
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