Provider Demographics
NPI:1487423646
Name:RUSSELL, CHARITY O (RN)
Entity type:Individual
Prefix:MS
First Name:CHARITY
Middle Name:O
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16583 FIFE WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1894
Mailing Address - Country:US
Mailing Address - Phone:301-523-6446
Mailing Address - Fax:
Practice Address - Street 1:16583 FIFE WAY
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1894
Practice Address - Country:US
Practice Address - Phone:301-523-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health