Individual
HOLLY ANN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
500 HARVARD ST SE, MINNEAPOLIS, MN 55455-0363
(612) 273-3000
Mailing address
15464 GALAXIE AVE APT 136, APPLE VALLEY, MN 55124-3163
(651) 587-0566
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86027517
MN
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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