Individual
JENNIFER CATHLEEN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5300 MILITARY RD, LEWISTON, NY 14092-1903
(716) 297-4800
Mailing address
5300 MILITARY RD, LEWISTON, NY 14092-1903
(716) 297-4800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
307524
NY
Other
Enumeration date
12/29/2015
Last updated
12/29/2015
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