Individual
MRS. GLORIA ELIZABETH RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2817 REILLY ST, FORT BRAGG, NC 28310-7324
(910) 584-3674
Mailing address
2817 REILLY ST, FORT BRAGG, NC 28310-7394
(910) 907-6900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RUSS-0AEOR1
NC
Other
Enumeration date
09/25/2019
Last updated
04/20/2021
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