Individual
MRS. JASMINE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21044 FREDERICK RD, GERMANTOWN, MD 20876-4132
(240) 238-5432
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 822-4355
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110009717
VA
363A00000X
Physician Assistant
Primary
C0008212
MD
Other
Enumeration date
04/07/2020
Last updated
02/20/2024
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