Individual
MRS. CHERIE JO LYNN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7450 ELMAN LN, AZLE, TX 76020-5402
(817) 444-6505
(817) 444-2206
Mailing address
7450 ELMAN LN, AZLE, TX 76020-5402
(817) 444-6505
(817) 444-2206
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
140580
TX
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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