THERESA A RUSSELL (NPI# 1629061981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629061981 |
| Entity Type | Individual |
| Full Name | THERESA A RUSSELL |
| Credential | FNP |
| Practice Address |
406 Ne 1st St Enterprise OR 97828-1168 |
| Practice Telephone | 5414264502 |
| Practice Fax Number | 5414266403 |
| Mailing Telephone | 5414264502 |
| Mailing Fax Number | 5414266403 |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2013-12-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
91000286 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | PACIFIC SOURCE | J054905 | 01 |
| OR | MEDICARE RAILROAD | 500008058 | 01 |
| OR | BCBS | 5966011 | 01 |
| OR | 276716 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295266674 | Theresa Russell | Social Worker | 350 N Federal Hwy, 715, Boynton Beach, FL 33435-4171 | 2017-03-27 |
| 1023372992 | Theresa Delores Russell | Physical Therapy Assistant | 11577 Rio Secco Rd, Peyton, CO 80831-4031 | 2012-06-26 |
| 1457750895 | Theresa M. Russell | Counselor | 428 S 36th St, Quincy, IL 62301-5924 | 2014-08-21 |
| 1487808119 | Theresa Russell | Nurse Practitioner | 200 1st St Sw, Rochester, MN 55905-0001 | 2008-11-07 |
| 1255465530 | Theresa Joanne Russell | Specialist | 5494 Pony Express Trail, Pollock Pines, CA 95726 | 2007-03-16 |
| Street Address |
406 NE 1ST ST |
| City | ENTERPRISE |
| State | OR |
| Zip Code | 97828-1168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578550489 | Lowell Edward Euhus | Family Medicine | 406 Ne 1st St, Enterprise, OR 97828-1168 | 2005-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275169393 | Celina N Taylor | Case Manager/Care Coordinator | 103 Or-82, Enterprise, OR 97828 | 2020-03-20 |
| 1295297794 | Kindra Dawn Peterson | Case Manager/Care Coordinator | 700 Walter Street Sp. 21, Enterprise, OR 97828 | 2019-04-03 |
| 1518472968 | Kurt Alan Boesger | Pharmacist | 306 West North Street, Enterprise, OR 97828 | 2017-12-07 |
| 1124539275 | Allen Schnetzky | Counselor | 207 Sw First St, Enterprise, OR 97828 | 2017-10-17 |
| 1033655758 | Belinda Gayle Buswell | Case Manager/Care Coordinator | 207 Sw First Street, Enterprise, OR 97828 | 2017-01-19 |
| 1073975918 | Danielle Rose Nash | Case Manager/Care Coordinator | Wallowa Valley Center for Wellness 201 Sw 2nd St, Enterprise, OR 97828 | 2016-03-21 |
| 1780040022 | Dolores Irene Beck | Counselor | 207 Sw 1st Street, Enterprise, OR 97828 | 2015-12-31 |
| 1245530344 | Olive Branch Family Health Inc | General Practice | 306 W North Street, Enterprise, OR 97828 | 2010-10-24 |
| 1952615163 | Red Cross United Drug, Inc. | Pharmacy | 306 West North St., Enterprise, OR 97828 | 2010-07-29 |
| 1386788131 | Gale A Barton | Chiropractor | 109 East Main St, Enterprise, OR 97828 | 2007-02-16 |
| Find all providers in zip 97828 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811514722 | Susan Maxine Wagner | Nurse Practitioner | 103 Hilton Cir, Enterprise, AL 36330-7815 | 2020-06-26 |
| 1285250670 | Dylan Reese Mccollough | Nurse Practitioner | 6582 Boll Weevil Cir, Enterprise, AL 36330-9424 | 2020-06-22 |
| 1336669472 | Jennifer Stewart | Nurse Practitioner | 114 Flatrock Dr, Enterprise, AL 36330-4457 | 2017-06-20 |
| 1528424215 | Affordable Integrated Medicine | Nurse Practitioner | 610 W North St Ste B, Enterprise, OR 97828-1427 | 2016-01-11 |
| 1689001596 | Abby Spitler Olive | Nurse Practitioner | 606 Boll Weevil Cir, Suite A, Enterprise, AL 36330-2734 | 2013-10-09 |
| 1154629178 | Ashley D Gray | Nurse Practitioner | 83a Old Mill Creek Rd, Enterprise, MS 39330-9649 | 2011-03-01 |
| 1447219886 | Michelle Diane Stewmon | Nurse Practitioner | 103 W Robertson Ct, Enterprise, AL 36330-2344 | 2006-03-23 |
| 1063925626 | Jessica E Poitevint | Nurse Practitioner | 105 E Watts St, Enterprise, AL 36330-2511 | 2017-11-06 |
| 1063956233 | Millicent R Harrison | Nurse Practitioner | 105 E Watts St, Enterprise, AL 36330-2511 | 2016-12-07 |
| 1811449812 | Hannah Elizabeth Mcqueen | Nurse Practitioner | 101 E Brunson St Ste 200, Enterprise, AL 36330-2500 | 2016-10-26 |
| Find all providers in ENTERPRISE | ||||
| City | ENTERPRISE |
| Zip Code | 97828 |
Please comment or provide details below to improve the information on THERESA A RUSSELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.