Ms Shelly Rae Russeff, APRN-CNP | |
105 N Indian Meridian Rd, Pauls Valley, OK 73075-9236 | |
(405) 207-9800 | |
(405) 207-9898 |
Full Name | Ms Shelly Rae Russeff |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 105 N Indian Meridian Rd, Pauls Valley, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053710053 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | R0058066 (Oklahoma) | Primary |
Entity Name | Board Of Regents Of The University Of Oklahoma - Ou Physicians |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801869250 PECOS PAC ID: 2860304334 Enrollment ID: O20031103000607 |
Entity Name | Saints Medical Group, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437195922 PECOS PAC ID: 7012914898 Enrollment ID: O20061109000189 |
Entity Name | Medical Resource Management Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104056365 PECOS PAC ID: 4082753918 Enrollment ID: O20100830000840 |
Entity Name | Medberry Health Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487301867 PECOS PAC ID: 0244627099 Enrollment ID: O20220715000227 |
Mailing Address | Practice Location Address |
---|---|
Ms Shelly Rae Russeff, APRN-CNP 301 E Seminole St Apt 2, Wynnewood, OK 73098-5629 Ph: (405) 207-1116 | Ms Shelly Rae Russeff, APRN-CNP 105 N Indian Meridian Rd, Pauls Valley, OK 73075-9236 Ph: (405) 207-9800 |
Letitia Lynn Jackson, APRN-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2000 W Grant Ave Ste 2, Pauls Valley, OK 73075 Phone: 405-238-3900 Fax: 405-238-3903 | |
Micki Richardson, APRN-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 105 N Indian Meridian Rd, Pauls Valley, OK 73075 Phone: 405-207-9800 | |
Michelle Martin, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 106 Burr Ave, Pauls Valley, OK 73075 Phone: 405-238-4633 | |
Mary Melinda Dennis, APRN-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 105 N Indian Meridian Rd, Pauls Valley, OK 73075 Phone: 405-207-9800 Fax: 405-207-9898 | |
Brett Avery Baldwin, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 415 W Guy Ave, Pauls Valley, OK 73075 Phone: 405-397-0035 Fax: 405-238-9342 | |
Marcus Shane Wahl, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Melville Dr, Pauls Valley, OK 73075 Phone: 405-224-8111 Fax: 405-825-4530 |