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Individual

AMANDA RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8380 HARRISON ST, LA VISTA, NE 68128-2918
(402) 592-7990
(402) 592-7377
Mailing address
8380 HARRISON ST, LA VISTA, NE 68128-2918

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12408
NE

Other

Enumeration date
11/25/2011
Last updated
11/25/2011
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