Individual
JANICE A RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
401 E ELM ST, CARSON CITY, MI 48811-0670
(989) 584-3107
(989) 584-6458
Mailing address
PO BOX 670, CARSON CITY, MI 48811-0670
(989) 584-3107
(989) 584-6458
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
5101010614
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4450218
—
MI
05
—
4450227
—
MI
Enumeration date
11/07/2006
Last updated
07/08/2007
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