Individual
BRIDGET LYNN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 MICHIGAN ST NE STE 4297, GRAND RAPIDS, MI 49503-2560
(616) 267-7900
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5020939
NC
363LC0200X
Critical Care Medicine Nurse Practitioner
4704211779
MI
363LG0600X
Gerontology Nurse Practitioner
4704211779
MI
Other
Enumeration date
08/15/2019
Last updated
02/11/2025
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