Individual
MRS. SHIRLEY LOVELL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
8102 CLEARVISTA PARKWAY, INDIANAPOLIS, IN 46256
(317) 849-8222
Mailing address
4327 SUNSHINE AVENUE, INDIANAPOLIS, IN 46228
(317) 293-1162
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000418A
IN
Other
Enumeration date
08/29/2006
Last updated
07/08/2007
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