Individual
JESSICA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(866) 686-2504
Mailing address
307 TRENT DR, DURHAM, NC 27710-3038
(919) 297-8343
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
226111
NC
363LF0000X
Family Nurse Practitioner
Primary
226111
NC
Other
Enumeration date
07/12/2012
Last updated
09/28/2025
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