Individual
JACQUELINE J. RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
114 BRADY CT, CARY, NC 27511-4554
(919) 526-0558
Mailing address
800 FINSBURY ST APT 5303, DURHAM, NC 27703-7632
(517) 899-2369
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
5021589
NC
Other
Enumeration date
01/31/2025
Last updated
01/31/2025
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