TANGELLA E RUSSELL CNP NPI 1275637639

NPI Information

NPI: 1275637639
Provider Name: TANGELLA E RUSSELL, CNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1267 HIGHWAY 54 W
SUITE 2200
FAYETTEVILLE, GA
ZIP 30214
Phone: (770) 716-0051
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Tangella E Russell, CNP is a family nurse practitioner in Fayetteville, GA with 25 years of experience. Tangella E Russell, CNP NPI is 1275637639. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1267 HIGHWAY 54 W
SUITE 2200
FAYETTEVILLE, GA
ZIP 30214-114
Phone: (770) 716-0051
Fax: (770) 716-0087

The NPI 1275637639 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/7/2006 and was last updated on 9/15/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	RN 116405	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	087974374G	MEDICAID	GEORGIA
2	Q25697	MEDICARE UPIN
3	202I502193	MEDICARE PIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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