Russell, Laura
Russell, Laura is an individual health care provider with primary practice located at 1109 E Reelfoot Ave Suite C, Union City TN 38261-5856. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Russell, Laura can be contacted via phone (731) 884-0600.Contact Information
Primary practice address
1109 E Reelfoot Ave Suite C
Union City TN 38261-5856
Phone: (731) 884-0600
Fax: (731) 885-6171
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | APN11001 | Tennessee |
Profile Details
| NPI number | 1710974761 |
|---|---|
| LBN Legal business name | Russell, Laura |
| Credentials | Certified Family Nurse Practitioner (CFNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710974761 | NPPES |
| Tennessee | Other | 166248 | BETTER HEALTH PLANS |
| Tennessee | Other | 34427 | BETTER HEALTH PLANS |
| Tennessee | MEDICAID | 3723214 | BETTER HEALTH PLANS |
| Tennessee | Other | 4103819 | BETTER HEALTH PLANS |
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