Individual
CARLYN MARIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8600 OLD GEORGETOWN RD, BETHESDA, MD 20814-1422
(301) 896-3100
Mailing address
26 STREAMSIDE PL, FALLING WATERS, WV 25419-4358
(240) 277-5959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R179138
MD
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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