1881945681 NPI number — MRS. ASHLEIGH STRICKLAND RUSSELL F.N.P.

Table of content: MRS. ASHLEIGH STRICKLAND RUSSELL F.N.P. (NPI 1881945681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881945681 NPI number — MRS. ASHLEIGH STRICKLAND RUSSELL F.N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUSSELL
Provider First Name:
ASHLEIGH
Provider Middle Name:
STRICKLAND
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
F.N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STRICKLAND
Provider Other First Name:
ASHLEIGH
Provider Other Middle Name:
ROSE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
F.N.P.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881945681
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
142 WILLOW POINT CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POOLER
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31322-3924
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-567-0352
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5690 OGEECHEE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAVANNAH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31405-9500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-567-0352
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2012

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: 363LF0000X , with the licence number:  RN225268 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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