Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACQUELINE MARIE RUSSELL, PMHNP-BC
ActiveJACQUELINE MARIE RUSSELL, PMHNP-BC is a Psychiatric/Mental Health Nurse Practitioner healthcare provider located in ENTERPRISE, Oregon. NPI 1720673577 is currently active in the NPPES registry. Verify at CMS.
Psychiatric/Mental Health Nurse Practitioner · ENTERPRISE, OR
Registration Details
- NPI Number
- 1720673577
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 3, 2021 (5.6512992565204 yrs)
- Last Updated
- Mar 1, 2024
- License
-
10013334 (OR)
Practice Information
- Address
-
606 MEDICAL PKWYENTERPRISE, OR, 978285140Browse OR providers · Browse ZIP 97828
- Phone
- 5414264524
- Fax
- 5414263035
- Primary Specialty
-
Psychiatric/Mental Health Nurse Practitioner
363LP0808X
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.