Individual
JILLIAN JULIA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
939 SOUTHBRIDGE ST, WORCESTER, MA 01610-2227
(508) 860-6589
Mailing address
222 BOSTON TPKE, SHREWSBURY, MA 01545-5224
(508) 853-2854
(508) 853-4354
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN265677
MA
Other
Enumeration date
03/26/2013
Last updated
08/09/2021
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