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NPI Code Detail

MEDICARE: RUSSELL DEAN PULLEN PA

MEDICARE: RUSSELL DEAN PULLEN PA
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
1363A00000XPhysician Assistant5615TN

General Provider Information

NPI Number : 1558381129
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUSSELL DEAN PULLEN PA
Provider Business Mailing Address
First Line : 10001 W INNOVATION DR STE 200
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-4851
Country : US
Telephone Number : 888-938-3838
Fax Number : 888-919-1083
Provider Business Practice Location Address
First Line : 341 WALLACE RD STE D
Second Line :
City : NASHVILLE
State : TN
Zip : 37211-8001
Country : US
Telephone Number : 615-832-2200
Fax Number : 615-832-2020
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 10/20/2025

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Directions to “ RUSSELL DEAN PULLEN PA” 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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