Individual
RUSSELL POYNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
5527 STEWART ST, MILTON, FL 32570-4303
(850) 983-5200
(850) 983-4816
Mailing address
PO BOX 929, MILTON, FL 32572-0929
(850) 983-5200
(850) 983-4816
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN 862932
FL
Other
Enumeration date
07/20/2007
Last updated
07/20/2007
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