Provider Demographics
NPI:1326778598
Name:RUSSELL, JOANNE DEE
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:DEE
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4862 STATE ROUTE 193
Mailing Address - Street 2:
Mailing Address - City:DORSET
Mailing Address - State:OH
Mailing Address - Zip Code:44032-9764
Mailing Address - Country:US
Mailing Address - Phone:144-064-5343
Mailing Address - Fax:
Practice Address - Street 1:4862 STATE ROUTE 193
Practice Address - Street 2:
Practice Address - City:DORSET
Practice Address - State:OH
Practice Address - Zip Code:44032-9764
Practice Address - Country:US
Practice Address - Phone:144-064-5343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-12
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker