Individual
MRS. AKIMYO CHAMPION RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6200-A OLD FRANCONIA ROAD, ALEXANDRIA, VA 22310
(703) 884-8494
(703) 313-0178
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024170178
VA
363LF0000X
Family Nurse Practitioner
5004213
NC
363LF0000X
Family Nurse Practitioner
R178581
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295928570
—
VA
Enumeration date
08/21/2007
Last updated
11/30/2022
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