Individual
ELIZABETH RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 1ST AVE NE, SUITE 200, BUFFALO, MN 55313-1568
(763) 682-0665
Mailing address
25 1ST AVE NE, SUITE 200, BUFFALO, MN 55313-1568
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R-224418-1
MN
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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