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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. JACQUELYN KAY RUSSELL, PA

Deactivated

MS. JACQUELYN KAY RUSSELL, PA is a Physician Assistant healthcare provider located in ILIAMNA, Alaska. NPI 1639156268 is deactivated in the NPPES registry. Verify at CMS.

Physician Assistant · ILIAMNA, AK

This NPI has been deactivated. The record was deactivated on August 16, 2024. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1639156268
Provider Type
Individual
Gender
Female
NPI Issued
Dec 23, 2005 (18.647540983607 yrs)
Last Updated
Sep 6, 2024
Deactivated
Aug 16, 2024
Licenses
085.004670 (IL)
023071 (NY)
PADA481 (AK)

Practice Information

Address
101 AIRPORT WAY
ILIAMNA, AK, 99606
Browse AK providers · Browse ZIP 99606
Phone
9075711818
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Physician Assistant
Additional Specialty
Physician Assistant

Other Physician Assistant Providers in ILIAMNA, AK

Name Credential NPI
ANNE ELIZABETH DAILEY PA 1952318735
SUZANNE MARGARET MILETTE PA-C 1952417792
RUTH SINGLETON ALVAREZ PA-C 1194815126
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.