Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ANTOINETTE RUSSELL
Active Sole ProprietorANTOINETTE RUSSELL is a Emergency Medical Technician, Intermediate healthcare provider located in LAKESIDE, Arizona. NPI 1457743916 is currently active in the NPPES registry. Verify at CMS.
Emergency Medical Technician, Intermediate · LAKESIDE, AZ
Registration Details
- NPI Number
- 1457743916
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 20, 2015 (11.496030741991 yrs)
- Last Updated
- Feb 20, 2015
- Licenses
-
111 (AZ)111 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2922 W WHITE MOUNTAIN BLVDLAKESIDE, AZ, 859296152Browse AZ providers · Browse ZIP 85929
- Phone
- 9283686112
- Fax
- 9283685643
- Primary Specialty
-
Emergency Medical Technician, Intermediate
146L00000X
- Additional Specialty
- Emergency Medical Technician, Basic
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.