Individual provider · Type 1 NPI

Madison Russell

Family Nurse Practitioner · Pocatello, ID

NPI number 1376480939 Active

Practice location

777 Hospital Way
Pocatello, ID 83201-5175

Mailing address

231 Ravine Dr
Pocatello, ID 83204-4026

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XF04260453 (ID)

Family Nurse Practitioner: Definition to come...

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About NPI 1376480939

Madison Russell's National Provider Identifier is 1376480939, issued on May 1, 2026. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Pocatello, ID. The record was last updated on May 1, 2026.