Search › Wisconsin › 101YA0400X
Connie Russell, CSAC
NPI 1447691167 · on the registry since 2013
Practice
- Address
- 712 55th St
Kenosha, WI 53140 - Phone
- (262) 842-0538
- Organisation at this address
- Mathew Mccarthy, Md, Sc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2013-07-11
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 Wisconsin