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NPI Profile for ANGELA R MULLINS RUSSELL in PENNINGTON GAP, VA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1417069725 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/31/2006 | |
| Last updated | 07/08/2007 - About 19 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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ANGELA R MULLINS RUSSELL
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ANGELA R MULLINS RUSSELL