Lora A Russell (NPI# 1114571429, PAC ID# 5799012589) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1114571429 |
| PAC ID by PECOS | 5799012589 |
| Professional Enrollment ID | I20190816002079 |
| Full Name | Lora A Russell |
| Organization Legal Name | ULTRA HEALTH LLC |
| Address |
1004 Holiday Ln Fulton KY 42041-8458 |
| Phone Number | 7313941145 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 6800186602 |
| Number of Group Practice Members | 32 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180093 | BAPTIST HEALTH MADISONVILLE |
| Address | Phone | Organization |
|---|---|---|
| 1004 Holiday Ln, Fulton, KY 42041-8458 | 7313941145 | ULTRA HEALTH LLC |
| Organization Legal Name | ULTRA HEALTH LLC |
| Physicians | 26 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephanie Pool | Nurse Practitioner | Ultra Health LLC | 402 W Farthing St, Mayfield, KY 42066-2900 |
| Kathy Gallaway | Nurse Practitioner | Ultra Health LLC | 107 Boyles Dr, Russellville, KY 42276-8838 |
| Amanda Nicole Dame | Nurse Practitioner | Ultra Health LLC | 950 Highpoint Dr, Hopkinsville, KY 42240-2570 |
| Deena D Carrico | Nurse Practitioner | Ultra Health LLC | 1004 Holiday Ln, Fulton, KY 42041-8458 |
| Loren S Carroll | Family Medicine | Ultra Health LLC | 36 Pemberton Cv, Jackson, TN 38305-5514 |
| Molly N Ledbetter | Nurse Practitioner | Ultra Health LLC | 36 Pemberton Cv, Jackson, TN 38305-5514 |
| Jessica Desir | Nurse Practitioner | Ultra Health LLC | 36 Pemberton Cv, Jackson, TN 38305-5514 |
| Melissa L Bolton | Nurse Practitioner | Ultra Health LLC | 36 Pemberton Cv, Jackson, TN 38305-5514 |
| Sheila Carlton | Nurse Practitioner | Ultra Health LLC | 36 Pemberton Cv, Jackson, TN 38305-5514 |
| Lauren Amber Wilson | Nurse Practitioner | Ultra Health LLC | 36 Pemberton Cv, Jackson, TN 38305-5514 |
| Street Address |
1004 HOLIDAY LN |
| City | FULTON |
| State | KY |
| Zip | 42041-8458 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deena D Carrico | Nurse Practitioner | Ultra Health LLC | 1004 Holiday Ln, Fulton, KY 42041-8458 |
| Adrian J Pellegrini | Internal Medicine | Ipc Pac Healthcare Services of Tennessee PC | 1004 Holiday Ln, Fulton, KY 42041-8458 |
| Dawn M. Kopp | Nurse Practitioner | Ipc Pac Healthcare Services of Tennessee PC | 1004 Holiday Ln, Fulton, KY 42041-8458 |
| Valentina Jenkins | Nurse Practitioner | Ipc Pac Healthcare Services of Tennessee PC | 1004 Holiday Ln, Fulton, KY 42041-8458 |
| Jacqueline Chapman North | Psychologist, Clinical | Ipc Pac Healthcare Services of Tennessee PC | 1004 Holiday Ln, Fulton, KY 42041-8458 |
| Erin Fulkerson | Psychologist, Clinical | Ipc Pac Healthcare Services of Tennessee PC | 1004 Holiday Ln, Fulton, KY 42041-8458 |
| Tammy Renee Gilbert | Nurse Practitioner | Ultra Health LLC | 1004 Holiday Ln, Fulton, KY 42041-8458 |
| Mary Stiff Miller | Psychologist, Clinical | Ipc Pac Healthcare Services of Tennessee PC | 1004 Holiday Ln, Fulton, KY 42041-8458 |
| Abby Vomastic | Nurse Practitioner | Ultra Health LLC | 1004 Holiday Ln, Fulton, KY 42041-8458 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Indu Malik | Family Practice | 227 Commerical Ave, Fulton, KY 42041-1528 | |
| Mallory Kate Bradley | Chiropractic | 420 Lake St, Fulton, KY 42041-1531 | |
| Daisy May Gamotin Benigno | Family Medicine | Pinelake Physician Practice LLC | 101 Main St, Fulton, KY 42041-1601 |
| Nathan Yoder | Physical Therapy | Parkway Regional Medical Clinic Inc | 2006 Holiday Ln, Suite 200, Fulton, KY 42041-8468 |
| City | FULTON |
| Zip Code | 42041 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | FULTON + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Lora A Russell.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.