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1588071369
MARYANNE RUSSELL
MINNETONKA, MN
NPI
1588071369
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: GA RN154916)
Enumeration Date
2014-07-14
Last Update Date
2020-09-20
Business Address
MARYANNE RUSSELL NP
9900 BREN RD E
MINNETONKA, MN 55343-9664
Phone number: 706-896-3708
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Mailing Address
MARYANNE RUSSELL NP
PO BOX 13
HIAWASSEE, GA 30546-0013
Phone number: 706-896-3708
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