LISA EVEALINE RUSSELL (NPI# 1821614371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821614371 |
| Entity Type | Individual |
| Full Name | LISA EVEALINE RUSSELL |
| Credential | HAB SPEC |
| Practice Address |
804 Industrial Park Rd Maxwelton WV 24957-8066 |
| Mailing Address |
Po Box 1001 Rupert WV 25984-1001 |
| Practice Telephone | 3044970500 |
| Mailing Telephone | 3046469083 |
| Enumeration Date | 2020-06-21 |
| Last Update Date | 2020-06-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 373H00000X | Day Training/Habilitation Specialist | WV | Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730514316 | Lisa Dawn Russell | Nurse Practitioner | 1343 County Road 1450 E, Carmi, IL 62821-5205 | 2013-09-13 |
| 1710290671 | Lisa R Russell | Occupational Therapist | 3999 Whispering Trails Ct, Hoffman Estates, IL 60192-1547 | 2010-07-21 |
| 1154774651 | Lisa Russell | Midwife | 4222 Mcintosh Ln, Sarasota, FL 34232-5027 | 2016-07-20 |
| 1467806406 | Lisa Russell | Specialist/Technologist, Other | 200 7th Ave, Suite 150, Santa Cruz, CA 95062-4668 | 2016-04-15 |
| 1871974865 | Lisa Pearse Russell | Nurse Practitioner | 346 Maine St, Lawrence, KS 66044-1393 | 2015-06-15 |
| 1639500937 | Lisa Russell | Physical Therapist | 555 Amory St, Jamaica Plain, MA 02130-2652 | 2013-12-12 |
| 1700150976 | Lisa Marie Russell | Dentist | 655 Clinic Rd, Suite 110, Hannibal, MO 63401-3647 | 2012-03-05 |
| 1649509498 | Lisa Marie Russell | Pharmacist | 1250 S Wheeler St, Jasper, TX 75951-5120 | 2009-12-08 |
| 1225108046 | Lisa A Russell | Physical Therapy Assistant | 1204 Frye St, Athens, TN 37303 | 2006-11-09 |
| 1760551212 | Lisa Michelle Russell | Massage Therapist | 1803 Miccosukee Commons Dr, Ste 202, Tallahassee, FL 32308 | 2006-11-07 |
| Street Address |
804 INDUSTRIAL PARK RD |
| City | MAXWELTON |
| State | WV |
| Zip Code | 24957-8066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679747893 | Mary Ann Shires | Social Worker | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2008-04-18 |
| 1568070290 | Erica Brownfield | Case Manager/Care Coordinator | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-07-20 |
| 1609493253 | Marcus Algelo Brandon | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-30 |
| 1669099313 | Luke Crane | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-29 |
| 1720605512 | Phyllis Nickell | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-29 |
| 1578180451 | Michelle Lorri Richards | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-26 |
| 1720605777 | Hailey Shae Mccallister | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-25 |
| 1942827902 | Susan Ann Barker | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-25 |
| 1053938027 | Amanda Hedrick | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-25 |
| 1295351351 | Lauren Thomas | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528417946 | Rainelle Medical Center, Inc. | Clinic/Center | 390 Industrial Park, Maxwelton, WV 24957 | 2016-06-07 |
| 1073616132 | Joseph F Bee | Dentist | 274 Erin Lane, Maxwelton, WV 24957-0274 | 2006-09-06 |
| 1972120806 | Amy Allison Myers | Day Training/Habilitation Specialist | 804 Industrial Drive, Maxwelton, WV 24957-0804 | 2020-06-26 |
| 1306362355 | Genoa Healthcare, LLC | Pharmacy | 804 Industrial Park Rd Rm 27, Maxwelton, WV 24957-8066 | 2017-08-21 |
| 1508246307 | Samantha Grimmett | Social Worker | 804 Industrial Park Rd Ste 1, Maxwelton, WV 24957-8066 | 2015-06-05 |
| 1467078626 | Jerrald Wayne Barker | Day Training/Habilitation Specialist | 804 Industrial Park Rd Ste 1, Maxwelton, WV 24957-8066 | 2020-06-23 |
| 1770109399 | Kathryn Dayle Keaton | Registered Nurse | 804 Industrial Park Rd Ste 1, Maxwelton, WV 24957-8066 | 2020-06-19 |
| 1972984490 | Seneca Health Services | Clinic/Center | 804 Industrial Park Rd Ste 1, Maxwelton, WV 24957-8066 | 2015-06-10 |
| 1336661834 | Rainelle Medical Center, Inc. | Pharmacy | 390 Industrial Park Rd, Maxwelton, WV 24957-8073 | 2017-07-17 |
| 1528587722 | Joshua Workman | Pharmacist | 390 Industrial Park Rd, Maxwelton, WV 24957-8073 | 2017-09-19 |
| Find all providers in zip 24957 | ||||
| Taxonomy Code | 373H00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Day Training/Habilitation Specialist |
| Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972120806 | Amy Allison Myers | Day Training/Habilitation Specialist | 804 Industrial Drive, Maxwelton, WV 24957-0804 | 2020-06-26 |
| 1609493253 | Marcus Algelo Brandon | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-30 |
| 1669099313 | Luke Crane | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-29 |
| 1720605512 | Phyllis Nickell | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-29 |
| 1578180451 | Michelle Lorri Richards | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-26 |
| 1720605777 | Hailey Shae Mccallister | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-25 |
| 1942827902 | Susan Ann Barker | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-25 |
| 1053938027 | Amanda Hedrick | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-25 |
| 1295351351 | Lauren Thomas | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-24 |
| 1639795784 | George Timothy Sheppard | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-24 |
| Find all providers in MAXWELTON | ||||
Please comment or provide details below to improve the information on LISA EVEALINE 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.