ELISSA RUSSELL

ROCKFORD, IL
NPI1225316722
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209008946)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: IL  209008946)
Enumeration Date2011-08-01
Last Update Date2018-07-27
Business Address
Mrs. ELISSA RUSSELL APN, CNP
1340 CHARLES ST SUITE 300
ROCKFORD, IL 61104
Phone number: 779-696-5888
Mailing Address
Mrs. ELISSA RUSSELL APN, CNP
PO BOX 78866
MILWAUKEE, WI 53278-8866
Phone number: 779-696-7150