Individual
JULIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 S LAMAR BLVD STE 103, OXFORD, MS 38655-5373
(662) 234-0119
(662) 513-9673
Mailing address
1189 DOGWOOD DR, TUPELO, MS 38801-9631
(662) 279-9599
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
902281
MS
Other
Enumeration date
09/06/2017
Last updated
12/06/2021
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