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General NPI Number Information
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NPI Number | 1790582559
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Entity Type | Individual
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Provider Name | RUSSELL L EDDINS MSN, APRN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 6218 W CORPORATE OAKS DR
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-8723
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Country | US
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Telephone | 352-346-3127
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Fax |
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Provider Business Mailing Address
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Address Line | 13954 KEY LARGO LN
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City | BROOKSVILLE
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State | FL
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Zip | 34604-1514
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Country | US
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Telephone | 561-303-4372
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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 | APRN11037848
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License Number State | FL
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