Individual
REBECCA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
740 HIGH ST, SUITE 1004, WILLIAMSPORT, PA 17701-3102
(570) 321-3300
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
MW010420
PA
Other
Enumeration date
09/21/2016
Last updated
12/07/2022
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