| Jillian Russell Aprn Llc | |
|
5913 Ne 67th St Silver Springs FL 34488-1137 | |
| (407) 670-8218 | |
| Not Available |
| Full Name | Jillian Russell Aprn Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5913 Ne 67th St, Silver Springs, Florida |
| Authorized Official Name and Position | Jillian Russell (PROVIDER) |
| Authorized Official Contact | 4076708218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jillian Russell Aprn Llc 5913 Ne 67th St Silver Springs FL 34488-1137 Ph: (407) 670-8218 | Jillian Russell Aprn Llc 5913 Ne 67th St Silver Springs FL 34488-1137 Ph: (407) 670-8218 |
| NPI Number | 1760176341 |
|---|---|
| Provider Enumeration Date | 06/06/2023 |
| Last Update Date | 06/06/2023 |
| Medicare PECOS PAC ID | 8820457732 |
|---|---|
| Medicare Enrollment ID | O20230710001816 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760176341 | NPI | - | NPPES |
| Q6X4V | Other | FL | BCBS |
| 18412200 | Medicaid | FL | |
| 0010398059 | Other | UHC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jillian E Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104287457 PECOS PAC ID: 5294016424 Enrollment ID: I20170103000136 |
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