Individual
HALEY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2410 ATHERHOLT RD, LYNCHBURG, VA 24501-2148
(434) 200-2712
(434) 200-2851
Mailing address
2410 ATHERHOLT RD, LYNCHBURG, VA 24501-2148
(434) 200-2712
(434) 200-2851
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024172898
VA
Other
Enumeration date
09/03/2015
Last updated
08/24/2021
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