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Contact Information

TINA M RUSSELL, MSN, APRN, FNP-C
15 OLD HUMBOLDT RD
JACKSON, TN38305-3506
 Phone: 731-256-6456
 Fax: 731-256-6475
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

General Practice

163WG0000X
Indicates primary specialty

NPI Profile & details for TINA M RUSSELL · (Female)

NPI Number 1295328342
Status Active
Credentials MSN, APRN, FNP-C
Entity Individual
Enumeration date 02/18/2021
Last updated 04/18/2026 - About 2 months ago
Sole proprietor 1 No
Identifiers
  • TN License # 153147
  • TN License # APN0000028980
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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