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1851302996
RUSSELL V. K. CARSON
MANDEVILLE, LA
NPI
1851302996
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: LA AP04417)
Enumeration Date
2006-08-11
Last Update Date
2013-09-27
Business Address
RUSSELL V. K. CARSON
2915 HIGHWAY 190
MANDEVILLE, LA 70471-3298
Phone number: 985-626-8106
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Mailing Address
RUSSELL V. K. CARSON
PO BOX 772 MINUTECLINIC CREDENTIALING
WOONSOCKET, RI 02895-0784
Phone number: 401-770-1669
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