Individual
MRS. JENNIFER RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1810 LINDBERG DR STE 2100, SLIDELL, LA 70458-8160
(985) 649-2700
(985) 649-2950
Mailing address
PO BOX 2209, SLIDELL, LA 70459-2209
(985) 649-2700
(985) 649-8488
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
224396
LA
Other
Enumeration date
03/04/2022
Last updated
03/04/2022
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