| NPI | 1417096868 |
|---|---|
| Former Name | REBBEKKAH CHRISTINE RUSSIAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704274418) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 9190412) |
| 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9347400) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-03-06 |