Individual
LINDA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2575 N COURTENAY PKWY, MERRITT ISLAND, FL 32953-4126
(321) 639-7639
(321) 639-5762
Mailing address
2575 N COURTENAY PKWY, MERRITT ISLAND, FL 32953-4126
(321) 639-7639
(321) 639-5762
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 5166225
FL
Other
Enumeration date
01/11/2008
Last updated
01/16/2008
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