Russell, Earl D

Russell, Earl D is an individual health care provider with primary practice located at 427 Highway 51 N , Brookhaven MS 39601-2350. 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, Earl D can be contacted via phone (601) 823-5301.

Contact Information

Primary practice address
427 Highway 51 N Brookhaven MS 39601-2350
Fax: (601) 833-8742
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R852034 Mississippi

Profile Details

NPI number 1447412275
LBN Legal business name Russell, Earl D
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2008
Last updated Jul 2nd, 2008 - about 16 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 1447412275 NPPES
Mississippi Other R852034 MS LICENSE

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