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NPI 1972485704

NPI 1972485704 : HEIDI ELLEN RUSSELL : VALENTINE, NE

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General NPI Number Information
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    NPI Number           |    1972485704
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    Entity Type          |    Individual 
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    Provider Name        |    HEIDI ELLEN RUSSELL
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/23/2025
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    Last Update Date     |    07/23/2025
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Provider Practice Location Address
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    Address Line         |    232 N RAY STREET 
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    City                 |    VALENTINE
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    State                |    NE
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    Zip                  |    69201-1937
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    Country              |    US
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    Telephone            |    402-376-1088
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    225 N VALENTINE ST 
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    City                 |    VALENTINE
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    State                |    NE
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    Zip                  |    69201-1937
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    Country              |    US
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    Telephone            |    402-322-3050
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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        |    3747P1801X
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    Taxonomy Name        |    Personal Care Attendant
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    License Number       |    
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    License Number State |    NE
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