Provider Demographics
NPI:1033717509
Name:RUSSELL, FAITH MARIE (RN)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:MARIE
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2056 E HICKORY HILL RD
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-3125
Mailing Address - Country:US
Mailing Address - Phone:940-293-3344
Mailing Address - Fax:
Practice Address - Street 1:2056 E HICKORY HILL RD
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-3125
Practice Address - Country:US
Practice Address - Phone:940-293-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1008354163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health