| NPI | 1689954034 | 
|---|---|
| Former Name | EMILY D RUSSELL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 007385)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 332301)  | 
| 363L00000X Nurse Practitioner (Licence: CT 007385)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: NM 336800)  | |
| Enumeration Date | 2011-08-17 | 
| Last Update Date | 2022-03-14 |