Individual
IVA CAROL RUSSELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2917 SUTTON OAKS CT, PLANT CITY, FL 33566-9609
(813) 707-8244
(813) 903-4812
Mailing address
2917 SUTTON OAKS CT, PLANT CITY, FL 33566-9609
(813) 707-8244
(813) 903-4812
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN 3379892
FL
Other
Enumeration date
03/16/2006
Last updated
07/08/2007
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