Individual
BENJAMIN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7500 MERCY RD STE 1355, OMAHA, NE 68124-2319
(402) 717-4866
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101320
NE
367500000X
Certified Registered Nurse Anesthetist
105361
KS
Other
Enumeration date
04/10/2015
Last updated
01/23/2023
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