person
Connie Russell
Public Health or Welfare Agency in Wapanucka, Oklahoma
NPI 1649630856

Connie Russell is a Public Health or Welfare Agency based in Wapanucka, OK. Connie Russell practices in Wapanucka, OK. The NPI Number for Connie Russell is 1649630856 and holds a License No. (Oklahoma).

The current practice location address for Connie Russell is 502 S Choctaw Ave, Wapanucka, OK and can be reached out via phone at 580-937-4288 and via fax at 580-937-4804.

Location: 502 S Choctaw Ave, Wapanucka, OK, 73461-9235
person
Provider Profile Details
NPI Number
1649630856
Provider Name
Connie Russell
Credential
Provider Entity Type
Individual
Gender
Female
Address
502 S Choctaw Ave, Wapanucka, OK, 73461-9235
Phone Number
580-937-4288
Fax Number
580-937-4804
Provider Enumeration Date
03/01/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100687480A 05 OK
institution
Provider Business Practice Location Address Details
Address
502 S Choctaw Ave
City
State
Zip
73461-9235
Phone Number
580-937-4288
Fax Number
580-937-4804
person
Provider Business Mailing Address Details
Address
502 S Choctaw Ave
City
State
Zip
73461-9235
Phone Number
580-937-4288
Fax Number
580-937-4804
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Public Health or Welfare
Speciality
-
Taxonomy
License No.
()
Definition
Definition to come...
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