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NPI Code Detail

MEDICARE: TAMICKA NASHEA RUSSELL

MEDICARE: TAMICKA NASHEA 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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1790647568
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMICKA NASHEA RUSSELL
Provider Business Mailing Address
First Line : 199 S CENTRAL AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43223-1301
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 199 S CENTRAL AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43223-1301
Country : US
Telephone Number : 614-274-9500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2025
Last Update Date : 12/01/2025

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Directions to “ TAMICKA NASHEA 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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