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
Phone: (601) 823-5301
Fax: (601) 833-8742
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447412275 | NPPES |
| Mississippi | Other | R852034 | MS LICENSE |
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