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Individual

WHITNEY RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
413 LITTLE CREEK CT, JACKSONVILLE, NC 28546-8737
(757) 869-4255
Mailing address
413 LITTLE CREEK CT, JACKSONVILLE, NC 28546-8737
(757) 869-4255

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86024460

Other

Enumeration date
07/22/2019
Last updated
07/22/2019
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