IndividualActive
Antoinette Russell
NPI 1457743916 · Paramedic · Lakeside, AZ
Provider details
- NPI number
- 1457743916
- Entity type
- Individual
- Primary specialty
- ParamedicEmergency Medical Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 111 (AZ)
Specialties & taxonomies
Emergency Medical Service Providers
Emergency Medical Service Providers
Practice location
2922 W White Mountain Blvd
Lakeside, AZ 85929-6152
Phone: (928) 368-6112
Fax: (928) 368-5643
Approximate (ZIP-level) locationGet directions
Mailing address
2922 W White Mountain Blvd
Lakeside, AZ 85929-6152
Registry dates
- Enumerated
- 2015-02-20
- Last updated
- 2015-02-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.