Individual
NASTASSYA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1540 FOUNDERS PL, CHARLOTTESVILLE, VA 22902-8733
(434) 422-4800
Mailing address
4640 OLD FREDERICKSBURG RD, MINERAL, VA 23117-2130
(804) 297-2641
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F08230267
VA
Other
Enumeration date
11/06/2023
Last updated
04/13/2024
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