Provider Demographics
NPI:1184499014
Name:RUSSELL, HOPE JEAN-MARIE
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:JEAN-MARIE
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 1:4760 BOTTOM LN
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-7714
Mailing Address - Country:US
Mailing Address - Phone:937-205-6083
Mailing Address - Fax:
Practice Address - Street 1:4760 BOTTOM LN
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-7714
Practice Address - Country:US
Practice Address - Phone:937-205-6083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker