person
Mary Theresa Russell, NP
Adult Health Nurse Practitioner in Indianapolis, Indiana
NPI 1770590374

Mary Theresa Russell is an Adult Health Nurse Practitioner based in Carson City, IN and is specialized in Adult Health. Mary Theresa Russell practices in Indianapolis, IN and has the professional credentials of NP. The NPI Number for Mary Theresa Russell is 1770590374 and holds a License No. 71002193A (Indiana).

The current practice location address for Mary Theresa Russell is 3834 S Emerson Ave Ste 100, Indianapolis, IN and can be reached out via phone at 317-782-1577 and via fax at 317-780-5549.

Location: 3834 S Emerson Ave Ste 100, Indianapolis, IN, 89702-3299
person
Provider Profile Details
NPI Number
1770590374
Provider Name
Mary Theresa Russell
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
3834 S Emerson Ave Ste 100, Indianapolis, IN, 89702-3299
Phone Number
317-782-1577
Fax Number
317-780-5549
Provider Enumeration Date
08/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200492000 05 IN
institution
Provider Business Practice Location Address Details
Address
3834 S Emerson Ave Ste 100
City
State
Zip
46203
Phone Number
317-782-1577
Fax Number
317-780-5549
person
Provider Business Mailing Address Details
Address
3834 S Emerson Ave Ste 100
City
State
Zip
46203
Phone Number
317-782-1577
Fax Number
317-780-5549
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
71002193A (Indiana)
Definition
Definition to come...
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