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1396520888
DATAVIA RUSSELL
BALTIMORE, MD
NPI
1396520888
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: MD LP56057)
Enumeration Date
2023-08-31
Last Update Date
2023-08-31
Business Address
DATAVIA RUSSELL LPN
821 N EUTAW ST
BALTIMORE, MD 21201-4648
Phone number: 410-225-9185
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Mailing Address
DATAVIA RUSSELL LPN
3913 NORFOLK AVE
BALTIMORE, MD 21216-1240
Phone number: 443-413-8732
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