Individual
DORIS A. RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
4256 N 36TH ST, MILWAUKEE, WI 53216-1718
(414) 406-1039
Mailing address
4256 N 36TH ST, MILWAUKEE, WI 53216-1718
(414) 406-1039
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
86035-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86035-030
REGISTERED NURSE LICENSE
WI
Enumeration date
06/25/2009
Last updated
06/25/2009
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