Russell, Jamie

Russell, Jamie is an individual health care provider with primary practice located at 365 Stout Drive, Suite 160 , Johnson City TN 37614-1703. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Russell, Jamie can be contacted via phone (423) 439-4225.

Contact Information

Primary practice address
365 Stout Drive, Suite 160 Johnson City TN 37614-1703
Phone: (423) 439-4225
Fax: (423) 439-4560
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 21637 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 21637 Tennessee

Profile Details

NPI number 1578015137
LBN Legal business name Russell, Jamie
Credentials APRN, FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2016
Last updated Jun 30th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578015137 NPPES
Tennessee Other 21637 LICENSE

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