Individual
RUSSELL DAVID CORYELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP-FNP
Contact information
Practice address
1455 S VALLEY DR STE B, LAS CRUCES, NM 88005-3165
(575) 526-6992
(575) 526-7983
Mailing address
1455 S VALLEY DR STE B, LAS CRUCES, NM 88005-3165
(575) 526-6992
(575) 526-7983
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-02762
NM
Other
Enumeration date
09/16/2015
Last updated
09/08/2020
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