Individual provider · Type 1 NPI
Jennifer Russell, A-G NP
Adult Health Nurse Practitioner · Los Angeles, CA
NPI number
1659791986
Active
Practice location
1441 Eastlake Ave
Los Angeles, CA 90089-5403
Mailing address
PO Box 31309
Los Angeles, CA 90031-0309
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 306506 (NY) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | NP95013177 (CA) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1659791986
Jennifer Russell, A-G NP's National Provider Identifier is 1659791986, issued on Apr 25, 2014. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Los Angeles, CA. The record was last updated on Nov 27, 2023.