Provider Demographics
NPI:1689490757
Name:RUSSELL, LONDYN B
Entity type:Individual
Prefix:
First Name:LONDYN
Middle Name:B
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3203 CARRIAGE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-3790
Mailing Address - Country:US
Mailing Address - Phone:484-213-8275
Mailing Address - Fax:
Practice Address - Street 1:3203 CARRIAGE CT
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-3790
Practice Address - Country:US
Practice Address - Phone:484-213-8275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion