Active NPI
Terri Lynne Russell, RN MS CNS
- Psychiatric/Mental Health Registered Nurse
- Waconia, MN
National Provider Identifier
1205838661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- R-122719-6
- Practice address
- 540 E 1St St
Waconia, MN 55387-1601 - Phone
- (952) 442-4437
- Fax
- (952) 442-3084
- NPI assigned
- Aug 15, 2005
- Last updated
- Jul 13, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | R-122719-6 | MN | Primary |
Addresses
Primary practice location
540 E 1St St
Waconia, MN 55387-1601
Mailing address
540 E 1St St
Waconia, MN 55387-1601
Phone (952) 442-4437
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6249427 | Other | MN | UBH-MEDICA |
| 07F62RU | Other | MN | BLUE CROSS BLUE SHIELD |
| 123169 | Other | MN | U-CARE |
| 1023258 | Other | MN | PREFERRED ONE |
| HP28174 | Other | MN | HEALTH PARTNERS |
Other names 1
- Terri Lynne Fowles
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Specialist, Master of Science, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-122719-6 | MN | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1205838661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 E 1ST ST",
"city": "WACONIA",
"state": "MN",
"postal_code": "553871601",
"telephone_number": "952-442-4437",
"fax_number": "952-442-3084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 E 1ST ST",
"city": "WACONIA",
"state": "MN",
"postal_code": "553871601",
"telephone_number": "952-442-4437",
"fax_number": "952-442-3084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "TERRI",
"middle_name": "LYNNE",
"credential": "RN MS CNS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-15",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "MN",
"license": "R-122719-6",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH-MEDICA",
"identifier": "6249427",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "07F62RU",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U-CARE",
"identifier": "123169",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1023258",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP28174",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TERRI",
"last_name": "FOWLES",
"middle_name": "LYNNE",
"credential": "RN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Waconia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.