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Contact Information

JEANNE M RUSSART, LPN
N1495 WILLOW LANE
JEANNE RUSSART
CAMPBELLSPORT, WI53010
 Phone: 920-533-4676
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Licensed Practical Nurse

164W00000X
Indicates primary specialty

NPI Profile & details for JEANNE M RUSSART · (Female)

NPI Number 1083627491
Status Active
Credentials LPN (Licensed Practical Nurse)
Entity Individual
Enumeration date 08/15/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 31627031
  • WI Medicaid 39893600
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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