Organization
CLAIRE RUSSELL FAMILY MEDICAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATINA R LEVINGSTON (MANAGER)
(903) 293-7093
Entity
Organization
Contact information
Practice address
300 W COLLIN RAYE DR STE 101B, DE QUEEN, AR 71832-2003
(903) 280-2813
Mailing address
300 W COLLIN RAYE DR STE 101B, DE QUEEN, AR 71832-2003
(903) 280-2813
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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