IMELDA TIVIDAD RUSSELL

RIVERDALE, MD
NPI1528163540
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: MD  AC000309)
Enumeration Date2006-09-14
Last Update Date2018-10-01
Business Address
Miss IMELDA TIVIDAD RUSSELL CRNP
6510 KENILWORTH AVE STE 2500
RIVERDALE, MD 20737-1346
Phone number: 410-997-1907
Mailing Address
Miss IMELDA TIVIDAD RUSSELL CRNP
6510 KENILWORTH AVE STE 2500
RIVERDALE, MD 20737-1346
Phone number: 109-971-9074
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