Individual provider · Type 1 NPI
Tina Marie Russell, MSN, APRN, FNP-C
Family Nurse Practitioner · Jackson, TN
NPI number
1295328342
Active
Practice location
15 Old Humboldt Rd
Jackson, TN 38305-3506
Fax (731) 256-6475
Mailing address
15 Old Humboldt Rd Ste A
Jackson, TN 38305-3506
Other practice locations
- 2565 N Washington Ave, Brownsville, TN 38012-1610 · (731) 772-4199
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 153147 (TN) |
| Family Nurse Practitioner Primary | 363LF0000X | APN0000028980 (TN) |
Family Nurse Practitioner: Definition to come...
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About NPI 1295328342
Tina Marie Russell, MSN, APRN, FNP-C's National Provider Identifier is 1295328342, issued on Feb 18, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Jackson, TN. The record was last updated on Apr 18, 2026.