Individual
ANGELLA M.A. RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
2104 W LABURNUM AVE, RICHMOND, VA 23227
(804) 354-8108
(804) 354-8075
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
0024172203
VA
363LG0600X
Gerontology Nurse Practitioner
Primary
0024172203
VA
Other
Enumeration date
11/26/2014
Last updated
06/28/2018
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