Individual
HAYLEY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 BLUEGRASS AVE, LOUISVILLE, KY 40215-1130
(502) 375-6643
Mailing address
1800 BLUEGRASS AVE, LOUISVILLE, KY 40215-1130
(502) 375-6643
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3011752
KY
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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