Penny Russell, LDO ABO NCLE

NPI 1295425734 · on the registry since 2023

Practice

Address: 17105 San Carlos Blvd
Fort Myers Beach, FL 33931
Phone: (239) 340-7071
Fax: (239) 466-9015
Organisation at this address: Wal-Mart Stores East Lp
Wal-Mart Stores East, Lp
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: 156FX1800X
156FX1800X
Licence states on file: FL
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2023-05-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida