Individual
KELLEY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1271 SURREY CIR, APT 4, ANCHORAGE, AK 99515-4227
(907) 229-8686
Mailing address
1271 SURREY CIR, APT 4, ANCHORAGE, AK 99515-4227
(907) 229-8686
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
NURR33276
AK
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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