Individual
MRS. LESLIE ANNE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 SILVERWOOD LN, ERIE, PA 16505-5208
(814) 838-4252
Mailing address
1310 SILVERWOOD LN, ERIE, PA 16505-5208
(814) 838-4252
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN279110
PA
Other
Enumeration date
08/05/2008
Last updated
08/05/2008
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