Individual provider · Type 1 NPI
Grace Ellen Russell
Medical Physician Assistant · Wilmington, NC
NPI number
1003744954
Active
Practice location
120 Gazebo Ct
Wilmington, NC 28409-5051
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | None listed |
Medical Physician Assistant: Definition to come...
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About NPI 1003744954
Grace Ellen Russell's National Provider Identifier is 1003744954, issued on May 11, 2026. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Wilmington, NC. The record was last updated on May 11, 2026.