Individual
RUSSELL V. K. CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2915 HIGHWAY 190, MANDEVILLE, LA 70471-3298
(985) 626-8106
Mailing address
PO BOX 772, MINUTECLINIC CREDENTIALING, WOONSOCKET, RI 02895-0784
(401) 770-1669
(401) 652-9787
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP04417
LA
Other
Enumeration date
08/11/2006
Last updated
09/27/2013
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