Russell, Peni Jean

Russell, Peni Jean is an sole proprietor health care provider with primary practice located at 283 County Road 264 , Nacogdoches TX 75965-0530. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Russell, Peni Jean can be contacted via phone (936) 564-8735.

Contact Information

Primary practice address
283 County Road 264 Nacogdoches TX 75965-0530
Fax: (936) 564-5033
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 589871 Texas

Profile Details

NPI number 1871878835
LBN Legal business name Russell, Peni Jean
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 20th, 2011
Last updated Oct 20th, 2011 - about 14 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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