Provider Demographics
NPI:1659881837
Name:HYJEK, RUSSELL JR (MSN APRN FNP-BC)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:
Last Name:HYJEK
Suffix:JR
Gender:M
Credentials:MSN APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 BALDWIN RD
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-3089
Mailing Address - Country:US
Mailing Address - Phone:810-245-5562
Mailing Address - Fax:
Practice Address - Street 1:944 BALDWIN RD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446
Practice Address - Country:US
Practice Address - Phone:810-202-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704283521163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse