Individual
ASHLEY NICOLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9390740
FL
367500000X
Certified Registered Nurse Anesthetist
11018019
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11018019
FL
Other
Enumeration date
04/06/2021
Last updated
04/19/2022
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