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1215715297
RUSSELL SANBORN
MANDEVILLE, LA
NPI
1215715297
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: LA 229532)
Enumeration Date
2023-09-20
Last Update Date
2023-09-20
Business Address
RUSSELL SANBORN FNP
231 SAINT ANN DR STE 2
MANDEVILLE, LA 70471-3476
Phone number: 985-624-5410
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Mailing Address
RUSSELL SANBORN FNP
67037 THACKERY ST
MANDEVILLE, LA 70471-6901
Phone number: 504-442-2199
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