Individual
KRISTINA DENIECE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
1901 N MACARTHUR BLVD, IRVING, TX 75061-2220
(972) 579-8280
Mailing address
300 E ASH LN APT 1525, EULESS, TX 76039-2431
(817) 455-4919
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
TX
Other
Enumeration date
08/23/2020
Last updated
09/14/2020
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