Individual
BRENDA NOVELLA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
576 JEFFERSON AVE, MCDONALD ARMY HEALTH CENTER, FORT EUSTIS, VA 23604-5548
(757) 314-7522
Mailing address
168 EASY ST, DUTTON, VA 23050-9734
(804) 725-7885
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024138348
VA
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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