Individual
MARIE PHAM-RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
3202 N 6TH ST, FORT SMITH, AR 72904-4164
(479) 783-3900
(479) 783-3905
Mailing address
3108 BROOKEN HILL DR, FORT SMITH, AR 72908-9248
(479) 783-0233
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
A001764
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165901758
—
AR
Enumeration date
09/19/2005
Last updated
03/20/2017
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