MR. RUSSELL DUALE (NPI# 1811393283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811393283 |
| Entity Type | Individual |
| Full Name | MR. RUSSELL DUALE |
| Credential | LPN |
| Practice Address |
Bldg 301 Andrews Ave Lyster Army Health Clininc Fort Rucker AL 36362 |
| Mailing Address |
301 Andrews Ave Bldg 301 Lahc Bldg Fort Rucker AL 36362 |
| Practice Telephone | 3342557746 |
| Mailing Telephone | 3342557747 |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2014-11-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 2-063888 | AL | Nursing Service Providers |
| Street Address |
BLDG 301 ANDREWS AVE LYSTER ARMY HEALTH CLININC |
| City | FORT RUCKER |
| State | AL |
| Zip Code | 36362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477721298 | Jennifer R Bennett | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave, Fort Rucker, AL 36362 | 2008-02-14 |
| 1669995866 | Audrey Ramos | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2017-07-19 |
| 1487177788 | Alexis Marulanda | Emergency Medical Technician, Paramedic | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2017-07-19 |
| 1154842078 | Eric Winston Pelkey | Emergency Medical Technician, Paramedic | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2017-06-30 |
| 1053831156 | Matthew Lester Davenport | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2017-06-21 |
| 1659801462 | Gaston Garcia | Emergency Medical Technician, Paramedic | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2017-06-14 |
| 1407386261 | James Vincent Shields | Emergency Medical Technician, Paramedic | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2017-06-14 |
| 1972047843 | Wales Rowe | Technician/Technologist | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2016-12-13 |
| 1275083065 | Zachary Daughdrill | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2016-10-05 |
| 1114370160 | Johnnie Robbins | Registered Nurse | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2016-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745571 | Rachel Kestler | Specialist | 4102 Gadiator Street, Fort Rucker, AL 36362 | 2020-09-22 |
| 1417589268 | Jacob Michael Lezon | Emergency Medical Technician, Basic | 30501 Nevins St., Ft. Rucker, AL 36362 | 2020-02-10 |
| 1225535388 | Rhonda Lewis Wesolek | Dental Hygienist | Bldg 4405, Innkeeper Street, Fort Rucker, AL 36362 | 2018-04-06 |
| 1770013369 | National Vision, Inc. | Technician/Technologist | Bldg 9214, Fort Rucker, AL 36362 | 2017-06-15 |
| 1750730958 | Teresa Morgan Knighten | Dental Hygienist | 4405 Innkeepers St, Fort Rucker, AL 36362 | 2016-06-08 |
| 1568826246 | David Virgil II | Technician, Other | 2218 6th Avenue Building 4102, Fort Rucker, AL 36362 | 2016-04-08 |
| 1356771257 | Robert E Smith | Emergency Medical Technician, Intermediate | Blding 301 Andrew Ave, Ft Rucker, AL 36362 | 2013-11-14 |
| 1548503469 | Lindsey Taylor Mendenhall | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave 1-223rd Hhc, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2013-03-28 |
| 1689913808 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Fort Rucker Bldg. 9214, Daleville, AL 36362 | 2013-02-07 |
| 1275880205 | Sandra Lynn Griffin Banner | Optometrist | 33 Endl Ave, Fort Rucker, AL 36362 | 2012-08-09 |
| Find all providers in zip 36362 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801287412 | Sharon Dickman | Licensed Practical Nurse | Bldg 300 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2015-02-18 |
| 1720401540 | Barbara Hayes | Licensed Practical Nurse | Bldg. 301, Andrews, Ave., Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2014-01-30 |
| 1275857351 | Kristina Siegrist | Licensed Practical Nurse | Bldg. 301 Andrews Avenue, Lyster Army Health Clnic, Fort Rucker, AL 36362-5333 | 2010-03-18 |
| 1801126826 | Catherine Marie Clark | Licensed Practical Nurse | Bldg. 310, Andrews Ave., Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2010-01-14 |
| 1730350646 | Mildred Ethlyn Noble | Licensed Practical Nurse | Building 301, Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2008-03-19 |
| 1225638059 | Mary Sue Mercer | Licensed Practical Nurse | 301 Andrews Ave, Fort Rucker, AL 36362 | 2020-10-30 |
| 1619577673 | Reagan Alanee Jacobs | Licensed Practical Nurse | 301 Andrews Ave, Fort Rucker, AL 36362 | 2020-10-29 |
| 1801429493 | Debra D Davis | Licensed Practical Nurse | 301 Andrews Ave, Fort Rucker, AL 36362 | 2020-02-21 |
| 1669004131 | Shelby C Davis | Licensed Practical Nurse | 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2020-02-12 |
| 1003395104 | Patrisha L Twyman | Licensed Practical Nurse | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2018-08-09 |
| Find all providers in FORT RUCKER | ||||
| City | FORT RUCKER |
| Zip Code | 36362 |
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| 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.