Individual provider · Type 1 NPI

Sandra G. Russell, FNP

Family Nurse Practitioner · Petal, MS

NPI number 1932219581 Active

Practice location

15 Pumping Station Rd
Petal, MS 39465-8325

Call (601) 583-1559 Map

Fax (601) 583-1573

Mailing address

415 S 28th Ave
Hattiesburg, MS 39401-7246

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000XR639834 (MS)
Family Nurse Practitioner Primary 363LF0000X639834 (MS)

Family Nurse Practitioner: Definition to come...

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About NPI 1932219581

Sandra G. Russell, FNP's National Provider Identifier is 1932219581, issued on Aug 30, 2006. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Petal, MS. The record was last updated on Jul 20, 2020.