Individual
ALI RENEE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CHW
Contact information
Practice address
1811 W 2ND ST STE 200, GRAND ISLAND, NE 68803-5463
(308) 289-6370
Mailing address
1118 W 11TH ST, GRAND ISLAND, NE 68801-4018
(308) 289-6370
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
NE
225700000X
Massage Therapist
Primary
3592
NE
Other
Enumeration date
09/03/2018
Last updated
05/04/2026
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