Individual
NICHOLAS STEPHEN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1128 N MAIN ST, MADISONVILLE, KY 42431-1265
(270) 825-2775
(270) 825-0413
Mailing address
1128 N MAIN ST, MADISONVILLE, KY 42431-1265
(270) 825-2775
(270) 825-0413
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
016504
KY
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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