Most Relevant Information
Provider Data
| NPI Number: | 1003578642 |
| Provider Name: | ANNA MARIE RUSSELL FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 95026495 |
Most Important Dates
| Enumeration Date: | 10/12/2021 |
| Last Updated: | 10/12/2021 |
Provider Practice Location
31 EASTER AVE
WEAVERVILLE
CA
960938054
Practice Location Phone/Fax
| Phone: | 5306234186 |
| Fax: | 5306234397 |
Provider Mailing Location
PO BOX 1229
WEAVERVILLE
CA
960931229
Provider Mailing Phone/Fax
| Phone: | 5306234186 |
| Fax: | 5306234397 |