Individual
GRAHAM E RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN, DNP-CRNA
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-2121
Mailing address
2700 E OVERLAND RD APT C212, MERIDIAN, ID 83642-8989
(971) 344-5717
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN768430
PA
Other
Enumeration date
01/09/2023
Last updated
12/30/2025
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