CONNIE RUSSELL
Nurse Practitioner - Family
Active
Individual
NPI: 1518509637
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Registered Nurse | 163W00000X | No | 366691-3102 (UT) |
| Nurse Practitioner - Family | 363LF0000X | Yes | 366691-4405 (UT) |
Frequently Asked Questions
NPI 1518509637 is the National Provider Identifier for CONNIE RUSSELL, a Nurse Practitioner - Family provider located in Salt Lake City, UT. This NPI was enumerated on October 9, 2019.
CONNIE RUSSELL practices at 1205 E BONNER WAY, Salt Lake City, UT 84117.
Quick Facts
- NPI
- 1518509637
- Type
- Individual
- Enumerated
- Oct 9, 2019
- Last Updated
- Oct 15, 2020
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