Lacy D Russell, APRN | |
268 E Maple St, Salyersville, KY 41465-8032 | |
(606) 349-5300 | |
(606) 349-5312 |
Full Name | Lacy D Russell |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 268 E Maple St, Salyersville, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275001869 | NPI | - | NPPES |
7100600540 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 3012873 (Kentucky) | Primary |
Entity Name | Aaron K. Jonan Memorial Clinic, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477569226 PECOS PAC ID: 5294632196 Enrollment ID: O20031218000126 |
Entity Name | Salyersville Medical Center, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215984711 PECOS PAC ID: 4385539501 Enrollment ID: O20040217000889 |
Mailing Address | Practice Location Address |
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Lacy D Russell, APRN 268 E Maple St, Salyersville, KY 41465-8032 Ph: (606) 349-5300 | Lacy D Russell, APRN 268 E Maple St, Salyersville, KY 41465-8032 Ph: (606) 349-5300 |
Heather Blair, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 940 Parkway Dr, Salyersville, KY 41465 Phone: 606-298-3412 | |
Maria Tackett, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 214 Beriah Blvd, Salyersville, KY 41465 Phone: 606-349-5126 Fax: 606-349-5123 | |
Mrs. Patsy Jackson, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 787 Parkway Dr, Salyersville, KY 41465 Phone: 606-889-3221 | |
Wendy S Martin, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 940 Parkway Dr, Salyersville, KY 41465 Phone: 606-349-5123 | |
Kristen Predmore, APRN, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 842 E Mountain Pkwy, Salyersville, KY 41465 Phone: 606-349-8100 Fax: 606-349-8150 | |
Sarah Ann Patrick, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Hc 61 Box 535, Salyersville, KY 41465 Phone: 606-349-7710 Fax: 606-349-7720 |