Individual
MAKAYLA LYNN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
51 PINSBAARI DR, ACOMA, NM 87034
(505) 552-5145
Mailing address
51 PINSBAARI DR, ACOMA, NM 87034
(505) 552-5145
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
G-2044
NM
Other
Enumeration date
05/12/2026
Last updated
05/12/2026
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