Individual
MS. HOLLY RENEE' RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
158 TANNER ST, STONEWALL, LA 71078-4455
(318) 925-2335
Mailing address
158 TANNER ST, STONEWALL, LA 71078-4455
(318) 925-2335
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN125144
LA
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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