Provider Demographics
NPI:1356966329
Name:RUSSELL, CHRISTINA MARIE (MIDWIFE)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:MIDWIFE
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MIDWIFE
Mailing Address - Street 1:290 WARWICK RD
Mailing Address - Street 2:
Mailing Address - City:ELVERSON
Mailing Address - State:PA
Mailing Address - Zip Code:19520-8920
Mailing Address - Country:US
Mailing Address - Phone:215-237-8575
Mailing Address - Fax:610-646-3754
Practice Address - Street 1:290 WARWICK RD
Practice Address - Street 2:
Practice Address - City:ELVERSON
Practice Address - State:PA
Practice Address - Zip Code:19520-8920
Practice Address - Country:US
Practice Address - Phone:215-237-8575
Practice Address - Fax:610-646-3754
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay