Individual
COLETTE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4412 W HEYERDAHL DR, PHOENIX, AZ 85087-5903
(623) 628-3814
Mailing address
4412 W HEYERDAHL DR, PHOENIX, AZ 85087-5903
(623) 628-3814
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
327403
AZ
Other
Enumeration date
06/14/2025
Last updated
08/08/2025
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