Individual
MS. AMY RENEE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
369 N MAIN ST, CRESTVIEW, FL 32536-3541
(850) 332-2589
(850) 398-8277
Mailing address
369 N MAIN ST, CRESTVIEW, FL 32536-3541
(850) 398-6963
(850) 398-8277
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9226261
FL
363LP2300X
Primary Care Nurse Practitioner
Primary
ARNP9226261
FL
Other
Enumeration date
08/27/2008
Last updated
02/07/2023
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