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Individual

ELANA RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
2200 ADA AVE STE 302, CONWAY, AR 72034-4985
(501) 932-0352
(501) 932-0354
Mailing address
2200 ADA AVE STE 302, CONWAY, AR 72034-4985
(501) 932-0352
(501) 932-0354

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0000371
CO
363LF0000X
Family Nurse Practitioner
Primary
A004254
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
214913758
AR
Enumeration date
01/29/2015
Last updated
03/22/2023
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