MEDICARE: RUSSELL SKOVLUND 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
1	163W00000X	Registered Nurse	R035846	SD

General Provider Information

NPI Number	:	1578494753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUSSELL SKOVLUND RN

Provider Business Mailing Address
First Line	:	325 E H ST
Second Line	:
City	:	IRON MOUNTAIN
State	:	MI
Zip	:	49801-4760
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4109 S BEDFORD AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57103-7669
Country	:	US
Telephone Number	:	215-823-5800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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