Individual
MELISSA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
974 SW CURTIS ST, PORT ST LUCIE, FL 34983-1906
(954) 822-4663
Mailing address
4371 NORTHLAKE BLVD # 152, N PALM BEACH, FL 33410-6253
(954) 822-4663
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5221802
FL
Other
Enumeration date
08/26/2025
Last updated
08/26/2025
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