Ivory Russ
Ivory Russ is a Home Health Agency in St Augustine, Florida. Practices as a sole proprietor. Licensed in Florida.
- Licensed in
- FL
- In the registry since
- 2022
Practice location Address checks out
300 Summer Breeze Way Apt 1106St Augustine, FL 32086-1804
Phone: (912) 342-9829
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Specialties & licences
| Home Health Agency (primary) | Taxonomy 251E00000X · Licence 31101007 (FL) |
|---|
Record details
| NPI number | 1255042826 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | December 5, 2022 |
| Last updated in NPPES | January 30, 2023 |
| Certification date | January 30, 2023 |
| Mailing address | 300 Summer Breeze Way Apt 1106, St Augustine, FL 32086-1804 |
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