Individual
MRS. JANICE LYNN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1600 TYSONS BLVD STE 1400, MC LEAN, VA 22102-4893
(267) 221-2658
Mailing address
1600 TYSONS BLVD STE 1400, MC LEAN, VA 22102-4893
(800) 367-5690
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN529580L
PA
Other
Enumeration date
01/25/2023
Last updated
01/25/2023
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