| Doctor Name: | VALERIE MARIE RUSSELL |
| NPI Number: | 1508053240 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 172311 |
| Business Practice Address: | 41 Feli Way Crawfordville, FL - 323272368 |
| Business Phone Number: | 8509263140 |
| Business Fax Number: | 8509263163 |
| Mailing Address: | 41 Feli Way, CRAWFORDVILLE |
| State: | FL |
| Postal Code: | 323272368 |
| Phone Number: | 8509263140 |
| Fax Number: | 8509263163 |
| NPI Enumeration Date: | 09/26/2007 |
| NPI Last Update Date: | 02/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 172311 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |