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1265837025
MARY RUSSELL
SAN MARCOS, CA
NPI
1265837025
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA FNP 95000801)
Enumeration Date
2014-10-22
Last Update Date
2014-10-22
Business Address
-- MARY RUSSELL FNP
1519 CLIFFTOP AVE
SAN MARCOS, CA 92078-1075
Phone number: 760-522-3941
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Mailing Address
-- MARY RUSSELL FNP
1519 CLIFFTOP AVE
SAN MARCOS, CA 92078-1075
Phone number: 760-522-3941
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