Individual
HOLLY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
890 BELTLINE RD, SPRINGFIELD, OR 97477-1091
(541) 868-7015
Mailing address
328 74TH ST, SPRINGFIELD, OR 97478-7287
(541) 868-7015
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
200841838RN
OR
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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