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Individual

COURTNEY RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1285 HIGHWAY 11W, BEAN STATION, TN 37708-5810
(865) 993-4300
(865) 993-4304
Mailing address
1923 SULPHUR SPRINGS RD, MORRISTOWN, TN 37813-5654
(423) 317-9344
(423) 714-2355

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
96039
TN

Other

Enumeration date
03/24/2021
Last updated
03/24/2021
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