NPI 1174121396
Comonique Russell
Practice location
- Address
- 2151 E Southern Ave APT 1082, Mesa, AZ 85204-5358
- Phone
- (347) 581-8028
- Fax
- (480) 892-4991
Registered specialties
Home Health Aide
Primary
Registry record
- NPI
- 1174121396
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 9 Oct 2020
- Record last updated
- 9 Oct 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.