Individual provider · Type 1 NPI

Jessica Russell

Licensed Practical Nurse · Waterford, MI

NPI number 1396192258 Active

Practice location

7712 Lake Ridge Dr
Waterford, MI 48327-4164

Call (248) 505-7204 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X4703109555 (MI)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1396192258

Jessica Russell's National Provider Identifier is 1396192258, issued on May 20, 2016. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Waterford, MI. The record was last updated on May 20, 2016.