JACQUELINE BLAKE RUSS

LOUISVILLE, KY
NPI1891279584
Other NameJACQUELINE BLAKE HIX
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: KY  3012682)
Enumeration Date2018-09-19
Last Update Date2021-04-02
Business Address
JACQUELINE BLAKE RUSS APRN
4123 DUTCHMANS LN STE 307
LOUISVILLE, KY 40207-4721
Phone number: 502-409-5600
Mailing Address
JACQUELINE BLAKE RUSS APRN
PO BOX 776351
CHICAGO, IL 60677-6351
Phone number: 502-588-9490
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