Individual
REBECCA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10701 ALLIANCE DR, CAMBY, IN 46113-8836
(317) 856-7083
(317) 856-7332
Mailing address
PO BOX 660025, INDIANAPOLIS, IN 46266-0001
(317) 856-7083
(317) 856-7332
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001656A
IN
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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