Individual
NATALIE P RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
289 S CULVER ST, LAWRENCEVILLE, GA 30046-4805
(415) 651-3458
Mailing address
PO BOX 861, GREENSBORO, GA 30642-0861
(502) 262-5386
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
298014
GA
Other
Enumeration date
01/06/2021
Last updated
08/17/2022
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