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General NPI Number Information
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NPI Number | 1639444052
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Entity Type | Individual
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Provider Name | ERIN RACHELLE RUSSELL MSN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/19/2012
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 5633 TYLERSVILLE RD STE B
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City | MASON
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State | OH
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Zip | 45040-2533
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Country | US
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Telephone | 513-622-9595
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Fax | 134-437-7774
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Provider Business Mailing Address
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Address Line | 5633 TYLERSVILLE RD STE B
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City | MASON
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State | OH
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Zip | 45040-2533
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Country | US
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Telephone | 513-622-9595
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Fax | 134-437-7774
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN.336271
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13245-NP
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License Number State | OH
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