NPI 1174929129

Jessica Russ, CCP

Practitioner Perfusionist Phoenix, AZ

Practice location

Address: 10930 N Tatum Blvd STE 103, Phoenix, AZ 85028-6069
Phone: (602) 263-7600
Fax: (602) 212-0365

Registered specialties

Perfusionist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 242T00000X Licence LP030 (NV)

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Registry record

NPI: 1174929129
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Nov 2014
Record last updated: 18 Nov 2014

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.