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Individual

CHELSEA LYNN RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
362 BEAL PKWY N STE 105, FORT WALTON BEACH, FL 32548-3926
(850) 862-3020
(850) 862-1363
Mailing address
362 BEAL PKWY N STE 105, FORT WALTON BEACH, FL 32548-3926
(850) 862-3020
(850) 862-1363

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
PA11842
TX
363A00000X
Physician Assistant
Primary
PA9117653
FL
363A00000X
Physician Assistant
PAC0860
ND

Other

Enumeration date
06/26/2018
Last updated
10/06/2023
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