Individual
MARIA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
616 GOVERNMENT CENTER WAY, EVANS, GA 30809-7604
(706) 868-3330
Mailing address
704 WHITTINGTONS RDG, EVANS, GA 30809-8015
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN052803
GA
Other
Enumeration date
01/26/2009
Last updated
01/26/2009
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