Provider Demographics
NPI:1497022545
Name:RUSSELL, MARIE MURPHY
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:MURPHY
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 1:39460 MIDDLETON ST
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1043
Mailing Address - Country:US
Mailing Address - Phone:860-539-0559
Mailing Address - Fax:
Practice Address - Street 1:39460 MIDDLETON ST
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1043
Practice Address - Country:US
Practice Address - Phone:860-539-0559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula