Russell, Meghan M

Russell, Meghan M is an individual health care provider with primary practice located at 4061 Old Peshtigo Road , Marinette WI 54143. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Russell, Meghan M can be contacted via phone (715) 732-8130.

Contact Information

Primary practice address
4061 Old Peshtigo Road Marinette WI 54143
Phone: (715) 732-8130
Fax: (715) 732-8131
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 195848-30 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 7746-033 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 7746-033 Wisconsin

Profile Details

NPI number 1538698618
LBN Legal business name Russell, Meghan M
Credentials DNP, FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2017
Last updated Jul 21st, 2022 - about 2 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 1538698618 NPPES
Wisconsin MEDICAID 100068863

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