Individual
MEGHAN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
417 LIBERTY ST, SPRINGFIELD, MA 01104-3736
(413) 747-0705
Mailing address
417 LIBERTY ST, SPRINGFIELD, MA 01104-3736
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN91223
MA
Other
Enumeration date
12/05/2022
Last updated
12/05/2022
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