1093502932 NPI number — MRS. JAHANNA RAPHINE ELLIS RUSSELL M.B.B.S

Table of content: MRS. JAHANNA RAPHINE ELLIS RUSSELL M.B.B.S (NPI 1093502932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093502932 NPI number — MRS. JAHANNA RAPHINE ELLIS RUSSELL M.B.B.S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ELLIS RUSSELL
Provider First Name:
JAHANNA
Provider Middle Name:
RAPHINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.B.B.S
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ELLIS
Provider Other First Name:
JAHANNA
Provider Other Middle Name:
RAPHINE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.B.B.S
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1093502932
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32 DULWICH DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KINGSTON 8
Provider Business Mailing Address State Name:
KINGSTON
Provider Business Mailing Address Postal Code:
00000
Provider Business Mailing Address Country Code:
JM
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32 DULWICH DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGSTON 8
Provider Business Practice Location Address State Name:
KINGSTON
Provider Business Practice Location Address Postal Code:
00000
Provider Business Practice Location Address Country Code:
JM
Provider Business Practice Location Address Telephone Number:
876-790-6476
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/23/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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