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Individual

STEPHEN KEN RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC

Contact information

Practice address
GENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL, 4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473
(573) 596-1490
Mailing address
ATTN: CPT STEPHEN RUSSELL, 5005 NORTH PIEDRAS STREET, EL PASO, TX 79920

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
34366.1665
WY

Other

Enumeration date
10/10/2018
Last updated
06/25/2025
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