Individual
MS. ELLA B RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1833 BOULEVARD STE 500, JACKSONVILLE, FL 32206-4377
(904) 253-1276
(904) 253-1973
Mailing address
1833 BOULEVARD, JACKSONVILLE, FL 32206-4382
(904) 253-1276
(904) 253-1973
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/09/2009
Last updated
11/09/2009
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