Individual
ELIZABETH LOUISE RUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
416 CONNABLE AVE, PETOSKEY, MI 49770-2212
(800) 248-6777
Mailing address
4397 LONG LAKE RD, CHEBOYGAN, MI 49721-9277
(231) 203-1973
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704358971
MI
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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