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Individual

MRS. ASHLEY LYNN RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
872 W HIGHWAY 40, VERNAL, UT 84078-2416
(435) 781-8899
Mailing address
255 N 750 E, VERNAL, UT 84078-1809
(435) 630-3259

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6238990-4405
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6238990-4405
UTAH DEPARTMENT OF COMMERCE DOPL LICENSE
UT
01
F02221129
AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD
Enumeration date
03/04/2022
Last updated
03/04/2022
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