Individual
MIKEISHA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
923 N 38TH ST APT 202, OMAHA, NE 68131-1229
(402) 306-3210
Mailing address
5745 N 35TH ST, OMAHA, NE 68111-1507
(402) 306-3210
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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