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Contact Information

REBECCA H RUSSELL, CNNP
2500 N STATE ST
JACKSON, MS39216-4500
 Phone: 601-984-5260
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Neonatal Intensive Care

163WN0002X
Indicates primary specialty

NPI Profile & details for REBECCA H RUSSELL · (Female)

NPI # 1679769657
Status Active
Credentials CNNP
Entity Individual
Enumeration date 09/24/2007
Last updated 05/22/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • MS License # 785141
  • MS License # R785141
  • LA Medicaid 2379577
  • MS Medicaid 06107379
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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