Individual
ANNEMARIE CHRISTINE RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM
Contact information
Practice address
14 CANYON RD, BOLINAS, CA 94924
(650) 279-6429
Mailing address
PO BOX 514, STINSON BEACH, CA 94970-0514
(650) 279-6429
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
LM343
CA
Other
Enumeration date
11/26/2012
Last updated
11/26/2012
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