Individual
MRS. LAURA KATHRYN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6060 PRIMACY PKWY STE 241, MEMPHIS, TN 38119-5743
(901) 725-5846
Mailing address
4036 N WALNUT GROVE CIR, MEMPHIS, TN 38117-2210
(901) 634-5003
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
23477
TN
163W00000X
Registered Nurse
135778
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
16735
TN
Other
Enumeration date
07/12/2011
Last updated
04/26/2024
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