Russell, Brian D

Russell, Brian D is an individual health care provider with primary practice located at 143 Longwater Dr , Norwell MA 02061-1683. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Russell, Brian D can be contacted via phone (781) 878-5200.

Contact Information

Primary practice address
143 Longwater Dr Norwell MA 02061-1683
Phone: (781) 878-5200
Fax: (781) 878-6750
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 14835 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN2330343 Massachusetts

Profile Details

NPI number 1992021315
LBN Legal business name Russell, Brian D
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2010
Last updated Mar 6th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992021315 NPPES
Tennessee MEDICAID 1523401
Tennessee Other P01504956
Tennessee MEDICAID 1992021315

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