Theresa A Russell is a Family in Enterprise, Oregon. Theresa A Russell practices all healthcare services and medical treatments related to Family. The NPI Number for Theresa A Russell is 1629061981. The last update date is 2013-12-13.
Theresa A Russell's current location address is 406 Ne 1st St, Enterprise, Oregon. You can contact this provider via phone number 5414264502 and fax number 5414266403. The mailing address for Theresa A Russell is 406 Ne 1st St, Enterprise, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Theresa A Russell |
|---|---|
| Address | 406 Ne 1st St, Enterprise, Oregon |
| Phone Number | 5414264502 |
| Fax Number | 5414266403 |
| Sole Proprietor | N |
| Credentials | FNP |
NPI Number Detail
| NPI Number | 1629061981 |
|---|---|
| Provider Enumeration Date | 2005-08-23 |
| Last Updated Date | 2013-12-13 |
Provider Mailing Address Detail
| Address | 406 Ne 1st St |
|---|---|
| City | Enterprise |
| State | Oregon (OR) |
| Post Code | 978281168 |
| Phone Number | 5414264502 |
| Fax Number | 5414266403 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 91000286 |
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Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5966011 | OR | BCBS | |
| J054905 | OR | PACIFIC SOURCE | |
| 276716 | OR | -- | |
| 500008058 | OR | MEDICARE RAILROAD |
Post Comment/ Review Below
What is the unique identifier code issued to Theresa A Russell by the Centers for Medicare & Medicaid Services?
The Theresa A Russell has been assigned the NPI (National Provider Identifier) 1629061981. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Theresa A Russell?
The Theresa A Russell is situated at 406 Ne 1St St, in the city of Enterprise, state of OR, with the zip code 978281168.
What is Theresa A Russell's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Theresa A Russell is Family, and the taxonomy classification code that categorizes this area of expertise is 363Lf0000X.
On what date did the Theresa A Russell receive the assignment of its 1629061981 from the Centers for Medicare & Medicaid Services?
The Theresa A Russell was issued its 1629061981 by the Centers for Medicare & Medicaid Services on 2005-08-23.
When was the information regarding Theresa A Russell, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Theresa A Russell, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2013-12-13.