Mary C Russell, APRN | |
180 Emory Rd, Blaine, TN 37709-2420 | |
(865) 933-4110 | |
(865) 933-4729 |
Full Name | Mary C Russell |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 180 Emory Rd, Blaine, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1447258652 | NPI | - | NPPES |
3342488 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | RN65079 (Tennessee) | Primary |
363LF0000X | Nurse Practitioner - Family | APN5921 (Tennessee) | Primary |
Entity Name | Faculty Internal Medicine Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417095308 PECOS PAC ID: 4789582305 Enrollment ID: O20031222000008 |
Mailing Address | Practice Location Address |
---|---|
Mary C Russell, APRN Department 888182, Knoxville, TN 37995-0001 Ph: (800) 355-3565 | Mary C Russell, APRN 180 Emory Rd, Blaine, TN 37709-2420 Ph: (865) 933-4110 |
Mrs. Chandra B. Blanken, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1066 Rutledge Pike, Blaine, TN 37709 Phone: 865-933-9477 Fax: 865-933-9466 | |
Crystal L Larrimore, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 880 Rutledge Pike, Blaine, TN 37709 Phone: 865-933-4110 Fax: 865-933-4729 | |
Wanda Fay White, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 586 Rutledge Pike, Blaine, TN 37709 Phone: 865-705-2624 | |
Tammy Gould, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1066 Rutledge Pike, Blaine, TN 37709 Phone: 865-933-9477 Fax: 865-933-9466 | |
Ms. Sharon Key Payne, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1066 Rutledge Pike, Blaine, TN 37709 Phone: 865-933-9477 Fax: 865-933-9466 | |
Rebecca Gail Patton, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1117 Cliff Top Rd, Blaine, TN 37709 Phone: 865-719-6290 |