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ERA RUSSELL HAIR LOSS SPECIALIST NPI 1447604178


NPI Information

NPI: 1447604178
Provider Name: ERA RUSSELL, HAIR LOSS SPECIALIST
Classification: Prosthetist - 224P00000X
Entity Type: Individual
Address:
2170 W POINT RD
SUITE 36
LAGRANGE, GA
ZIP 30240
Phone: (762) 323-7874
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Era Russell, HAIR LOSS SPECIALIST is a prosthetist in Lagrange, GA. The provider is a health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. Era Russell, HAIR LOSS SPECIALIST NPI is 1447604178. 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:

2170 W POINT RD
SUITE 36
LAGRANGE, GA
ZIP 30240-007
Phone: (762) 323-7874

The enumeration date for this NPI number is 4/19/2016 and was last updated on 11/1/2021.


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
1225000000XOrthotic FitterGEORGIANo
2224P00000XProsthetist224P00000XGEORGIAYes

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 Other Provider Identifier Issuer
17708MEDICAIDGEORGIA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.