Individual
JAMIE LYNN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4937 OLD COUNTRY CLUB RD, WINSTON SALEM, NC 27104-5071
(336) 718-4510
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5008756
NC
Other
Enumeration date
06/14/2016
Last updated
10/01/2025
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