| Doctor Name: | COLLEEN HENDERSON RUSSELL |
| NPI Number: | 1427282003 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD |
| License Number: | L000737 |
| Business Practice Address: | 1238 Huffman Mill Rd Burlington, NC - 272158700 |
| Business Phone Number: | 3365388173 |
| Business Fax Number: | 3365388033 |
| Mailing Address: | 1238 Huffman Mill Rd, BURLINGTON |
| State: | NC |
| Postal Code: | 272158700 |
| Phone Number: | 3365388173 |
| Fax Number: | 3365388033 |
| NPI Enumeration Date: | 05/11/2009 |
| NPI Last Update Date: | 05/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | L000737 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |