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NPI Code Detail

MEDICARE: VICTORIA RUSSELL

MEDICARE: VICTORIA RUSSELL
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
1171M00000XCase Manager/Care Coordinator
2101Y00000XCounselor

General Provider Information

NPI Number : 1407213309
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA RUSSELL
Provider Business Mailing Address
First Line : 4606 LEE ST
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71302-3235
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4606 LEE ST
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71302-3235
Country : US
Telephone Number : 318-441-1105
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2016
Last Update Date : 07/24/2019

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Directions to “ VICTORIA RUSSELL ” Practice Location

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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.

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