Individual
ERICA ROSE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3975 FOXFIRE DR, ZANESVILLE, OH 43701-9362
(740) 661-5028
Mailing address
3975 FOXFIRE DR, ZANESVILLE, OH 43701-9362
(740) 661-5028
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
136136-M-IV
OH
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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