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Taylor Renee Russell
Family Nurse Practitioner in Wagoner, Oklahoma
NPI 1881271864

Taylor Renee Russell is a Family Nurse Practitioner based in Wagoner, OK and is specialized in Family. Taylor Renee Russell practices in Wagoner, OK. The NPI Number for Taylor Renee Russell is 1881271864 and holds a License No. 201054 (Oklahoma).

The current practice location address for Taylor Renee Russell is 1202 W Cherokee St Ste E, Wagoner, OK and can be reached out via phone at 918-485-1877.

Location: 1202 W Cherokee St Ste E, Wagoner, OK, 74467-4629
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1881271864
Provider Name
Taylor Renee Russell
Credential
Provider Entity Type
Individual
Gender
Female
Address
1202 W Cherokee St Ste E, Wagoner, OK, 74467-4629
Phone Number
918-485-1877
Fax Number
Provider Enumeration Date
03/26/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200979620A 05 OK
institution
Provider Business Practice Location Address Details
Address
1202 W Cherokee St Ste E
City
Wagoner
State
Oklahoma
Zip
74467-4629
Phone Number
918-485-1877
Fax Number
person
Provider Business Mailing Address Details
Address
1202 W Cherokee St Ste E
City
Wagoner
State
Oklahoma
Zip
74467-4629
Phone Number
918-485-1877
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
201054 (Oklahoma)
Definition
Definition to come...
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