Provider Demographics
NPI:1568845568
Name:RUSSELL, JOAN HANNAH (MSN, RN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:HANNAH
Last Name:RUSSELL
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Gender:F
Credentials:MSN, RN, NP-C
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Mailing Address - Street 1:2201 MACARTHUR DR
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-3161
Mailing Address - Country:US
Mailing Address - Phone:254-202-7130
Mailing Address - Fax:254-202-7149
Practice Address - Street 1:2201 MACARTHUR DR
Practice Address - Street 2:SUITE 2200
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-3161
Practice Address - Country:US
Practice Address - Phone:254-202-7130
Practice Address - Fax:254-202-7149
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2024-01-25
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Provider Licenses
StateLicense IDTaxonomies
TXAP128459363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily