DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MS. SHANNON R RUSSOM N.P.

MEDICARE: MS. SHANNON R RUSSOM N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1010017858VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2150268OTHERVTMVP
358796OTHERVTBLUE SHIELD
46309101OTHERVTAPEX

General Provider Information

NPI Number : 1013948850
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHANNON R RUSSOM N.P.
Provider Business Mailing Address
First Line : 87 CARSE RD
Second Line :
City : HUNTINGTON
State : VT
Zip : 05462-9550
Country : US
Telephone Number : 802-434-4195
Fax Number :
Provider Business Practice Location Address
First Line : 353 BLAIR PARK RD
Second Line :
City : WILLISTON
State : VT
Zip : 05495-7530
Country : US
Telephone Number : 802-847-1600
Fax Number : 802-847-7184
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 07/08/2007

Similar Medicare Providers

1639126774 — BONITTA C STEUER CNM
Practice Location Address:
353 BLAIR PARK RD
WILLISTON, VT
05495-7530
Practice Phone: 802-847-1400
Practice Fax:
1619905072 — PAMELA LEE JACKSON M.D.
Practice Location Address:
353 BLAIR PARK RD
WILLISTON, VT
05495-7530
Practice Phone: 802-847-1440
Practice Fax: 802-847-3014
1215952890 — DR. ANN S WITTPENN M.D.
Practice Location Address:
353 BLAIR PARK RD
WILLISTON, VT
05495-7530
Practice Phone: 802-847-1440
Practice Fax:
1467470971 — MS. DARLA E WITMER ARNP
Practice Location Address:
353 BLAIR PARK RD , GIVEN HEALTH CARE
WILLISTON, VT
05495-7530
Practice Phone: 802-847-1470
Practice Fax: 802-847-7135
1306865183 — ELIOT W. NELSON M.D.
Practice Location Address:
353 BLAIR PARK RD
WILLISTON, VT
05495-7530
Practice Phone: 802-847-1440
Practice Fax: 802-847-3014
1770507477 — SANDRA GAIL WOOD CNM
Practice Location Address:
353 BLAIR PARK RD
WILLISTON, VT
05495-7530
Practice Phone: 802-847-1600
Practice Fax:

Directions to “ MS. SHANNON R RUSSOM N.P.” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.