Russell, Eileen Avis

Russell, Eileen Avis is an individual health care provider with primary practice located at Hwy 160/163 Building Ka 2010 , Kayenta AZ 86033-0368. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Emergency. Nursing Service Providers / Registered Nurse is her primary health care specialty. Russell, Eileen Avis can be contacted via phone (928) 697-4100.

Contact Information

Primary practice address
Hwy 160/163 Building Ka 2010 Kayenta AZ 86033-0368
Phone: (928) 697-4100
Fax: (928) 697-4029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN071967 Arizona
Nursing Service Providers / Emergency 163WE0003X RN071967 Arizona

Profile Details

NPI number 1376785659
LBN Legal business name Russell, Eileen Avis
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2009
Last updated Apr 7th, 2009 - about 15 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 1376785659 NPPES
Arizona MEDICAID 060012

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