Individual
BILLIE J RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4348 SOUTHPOINT BLVD STE 100, JACKSONVILLE, FL 32216-0903
(248) 434-6169
Mailing address
756 COUNTY ROAD 13 SOUTH, ST. AUGUSTINE, FL 32092
(904) 501-1903
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
315762
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
315762
ARNP LICENSE
FL
Enumeration date
01/05/2007
Last updated
10/09/2023
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