MRS. KELLY SHANNON RUSSELL (NPI# 1538375233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538375233 |
| Entity Type | Individual |
| Full Name | MRS. KELLY SHANNON RUSSELL |
| Credential | APRN-CNP |
| Practice Address |
200 N Easton Allen OK 74825-9713 |
| Mailing Address |
200 Easton Street Allen OK 74825 |
| Practice Telephone | 5808571300 |
| Mailing Telephone | 5808571300 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2019-01-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
0050643 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
0050643 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326468729 | Kelly Russell | Counselor | 3415 Se Powell Blvd Trillium Family Services, Portland, OR 97202 | 2014-04-24 |
| 1376829838 | Kelly C Russell | Counselor | 24 Pleasant St Rear, Newburyport, MA 01950-2610 | 2011-10-28 |
| 1336244763 | Kelly Gravino Russell | Social Worker | 16 Bush Hill Rd, Ipswich, MA 01938-1642 | 2006-09-13 |
| 1154957652 | Kelly Russell | Advanced Practice Midwife | 101 Dudley St, Providence, RI 02905-2401 | 2020-03-16 |
| 1942770409 | Kelly Leonora Russell | Counselor | 611 12th Ave S, Seattle, WA 98144-2007 | 2018-11-27 |
| 1992179535 | Kelly Marie Spegel Russell | Psychologist | 1843 Rw Berends Dr Sw, Wyoming, MI 49519-4955 | 2015-11-19 |
| 1346591898 | Kelly Hanh Russell | Physician Assistant | 1375 N 10th Ave, Stayton, OR 97383 | 2012-09-24 |
| 1205816923 | Kelly Yvette Russell | Anesthesiology | 1850 N Central Ave, Ste1600, Phoenix, AZ 85004-4527 | 2006-01-19 |
| Street Address |
200 N EASTON |
| City | ALLEN |
| State | OK |
| Zip Code | 74825-9713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205876752 | Rural Health Care Innovations | Family Medicine | 200 N Easton, Allen, OK 74825-0250 | 2006-06-06 |
| 1194287086 | Tri-county Primary Care LLC | Family Medicine | 200 N Easton, Allen, OK 74825-9713 | 2019-04-01 |
| 1942357215 | Mary Kathryn Machado | Nurse Practitioner | 200 N Easton, Allen, OK 74825-9713 | 2007-01-05 |
| 1881794295 | Peggy Sue Atwood | Physician Assistant | 200 N Easton, Allen, OK 74825-9713 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912365685 | Krystal Shephard | Home Health | 208 E. Broadway Ave., Allen, OKLAHOMA 74825 | 2016-02-09 |
| 1174942361 | Holdenville Hospital Authority | Clinic/Center | 202 W Broadway, Allen, OK 74825 | 2014-04-15 |
| 1932557816 | Holdenville Hospital Authority | Clinic/Center | 202 W Broadway, Allen, OK 74825 | 2016-06-01 |
| 1073983961 | Heather Prentice | Registered Nurse | 202 West Broadway, Allen, OK 74825 | 2015-10-05 |
| 1265491237 | Jeffry Michael Bryen | Physician Assistant | 200 N. Easton, Allen, OK 74825-0250 | 2006-03-20 |
| 1891871885 | Holdenville General Hospital Scholarship Fund Inc | Clinic/Center | 202 West Broadway, Allen, OK 74825-0350 | 2006-10-31 |
| 1245514181 | Allen Public Schools | Local Education Agency (LEA) | 110 North Richmond, Allen, OK 74825-0430 | 2011-10-10 |
| 1912470949 | Lafave Melton Medical Inc | Family Medicine | 501 E Conway, Allen, OK 74825-2904 | 2019-01-02 |
| 1669840831 | Peggy Sue Rinehart | Peer Specialist | 15306 County Road 3680, Allen, OK 74825-6948 | 2015-09-04 |
| 1366529034 | Allen Neighborhood Pharmacy Inc | Pharmacy | 200 E Lexington, 200 East Lexington, Allen, OK 74825-9224 | 2006-11-01 |
| Find all providers in zip 74825 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831729920 | Sheila Metzger | Nurse Practitioner | 2550 W Franklin Rd, Norman, OK 73069-8012 | 2020-01-17 |
| 1295380269 | Meisha Hall | Nurse Practitioner | 2508 W Huntsville St, Broken Arrow, OK 74011-6124 | 2019-08-07 |
| 1851896237 | Leslie King | Nurse Practitioner | 4809 East 89th Street South, Suite 100, Tulsa, OK 74137 | 2018-03-27 |
| 1437695715 | Erika Rumble | Nurse Practitioner | 10901 E 48th Street S, Tulsa, OK 74146-5830 | 2017-01-11 |
| 1083073365 | Kendra Seccombe | Nurse Practitioner | 161 Eco Friendly Dr, Suite 201, Muskogee, OK 74401-5100 | 2016-02-16 |
| 1710384870 | Melisa Dean | Nurse Practitioner | 700 S Telephone Rd Ste 401, Moore, OK 73160-2548 | 2014-12-04 |
| 1356766315 | Brianna Weathers | Nurse Practitioner | 401 W Tamarack Rd, Altus, OK 73521-1529 | 2014-02-27 |
| 1932473568 | Julie Claire Styles | Nurse Practitioner | 1540 N Lewis Ave, Tulsa, OK 74110-2535 | 2012-02-29 |
| 1376825596 | Jaclyn Danielle Maphies | Nurse Practitioner | 800 N.e. 10th Street, Suite 2100, Oklahoma City, OK 73104-5418 | 2011-09-14 |
| 1104124502 | Toby Lea Miller | Nurse Practitioner | 1603 W 9th Ave, Stillwater, OK 74074-5202 | 2011-03-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MRS. KELLY SHANNON RUSSELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.