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NPI Code Detail

MEDICARE: BRITTNEY RUSSELL RN

MEDICARE:   BRITTNEY  RUSSELL  RN
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
1163W00000XRegistered Nurse815163CA

General Provider Information

NPI Number : 1376935403
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTNEY RUSSELL RN
Provider Business Mailing Address
First Line : 4516 BRANDT WAY
Second Line :
City : NORTH HIGHLANDS
State : CA
Zip : 95660-3904
Country : US
Telephone Number : 406-580-7024
Fax Number :
Provider Business Practice Location Address
First Line : 1090 RIO LN
Second Line :
City : SACRAMENTO
State : CA
Zip : 95822-1706
Country : US
Telephone Number : 916-446-2506
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2015
Last Update Date : 02/26/2015

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