Individual provider · Type 1 NPI
Connie Russell
Public Health or Welfare Agency · Wapanucka, OK
NPI number
1649630856
Active
Practice location
502 S Choctaw Ave
Wapanucka, OK 73461-9235
Fax (580) 937-4804
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Public Health or Welfare Agency Primary | 251K00000X | None listed |
Public Health or Welfare Agency: Definition to come...
About NPI 1649630856
Connie Russell's National Provider Identifier is 1649630856, issued on Mar 1, 2016. The primary taxonomy on file is Public Health or Welfare Agency (251K00000X), and the practice location is in Wapanucka, OK. The record was last updated on Mar 1, 2016.