Individual
ANGELA KRISTIN RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 266-2911
Mailing address
16313 ALLEN RD, HARLAN, IN 46743-9727
(260) 750-9024
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
28190806A
IN
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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