Individual
AMANDA NICOLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
419 N SEMINARY ST, MADISONVILLE, KY 42431-1515
(731) 394-1145
Mailing address
PO BOX 269084, DEPT 1102, OKLAHOMA CITY, OK 73126
(731) 394-1145
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3012241
KY
Other
Enumeration date
05/22/2018
Last updated
01/15/2025
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