Individual
SHANNON MCKENZEE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6333 CENTER DR # 16, NORFOLK, VA 23502-4126
(757) 252-9500
Mailing address
6333 CENTER DR BLDG 16, NORFOLK, VA 23502-4126
(757) 252-9500
(757) 962-9801
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024184645
VA
Other
Enumeration date
07/11/2022
Last updated
11/30/2022
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