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Individual

TAMARA LOU RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
6826 NAWADAHA BLVD, ORLANDO, FL 32818-5365
(407) 864-0876
Mailing address
6826 NAWADAHA BLVD, ORLANDO, FL 32818-5365
(407) 864-0876

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APRN2813032
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN2813032
FL

Other

Enumeration date
08/26/2014
Last updated
06/09/2021
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