Individual
MRS. CATHLEEN A RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6842 CRAIG ROAD, BATH, NY 14810
(585) 278-6225
Mailing address
6842 CRAIG ROAD, BATH, NY 14810
(585) 278-6225
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2527961
NY
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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