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General NPI Number Information
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NPI Number | 1386225514
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Entity Type | Individual
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Provider Name | LAUREN VICTORIA RUSSELL-SMITH FNP
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Gender | Female
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 33100 COUNTY ROAD 31
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City | DAVIS
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State | CA
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Zip | 95616-9523
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Country | US
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Telephone | 530-702-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 8123 HELMSDALE DR
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City | SACRAMENTO
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State | CA
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Zip | 95828-5599
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Country | US
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Telephone | 601-850-6617
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 28562
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License Number State | TN
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