Individual
HEATHER A RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 WYOMING ST, ANESTHESIA DEPT, DAYTON, OH 45409
(937) 208-4380
(937) 208-3843
Mailing address
1 WYOMING ST, ANESTHESIA DEPT, DAYTON, OH 45409
(937) 208-4380
(937) 208-3843
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
322879
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
322897
RN
OH
Enumeration date
01/25/2012
Last updated
01/25/2012
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