Individual
MRS. BRIDGET RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14903 JANET LN, MABELVALE, AR 72103-5900
(501) 483-7806
Mailing address
14903 JANET LN, MABELVALE, AR 72103-5900
(501) 483-7806
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
214234
AR
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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