Individual
STEPHANIE MAY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
201 N BROADWAY ST, BALTIMORE, MD 21287-0031
(410) 955-8964
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-2704
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R212338
MD
363LP2300X
Primary Care Nurse Practitioner
R212338
MD
Other
Enumeration date
07/18/2023
Last updated
08/04/2023
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