Leslie Anne Russell

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN279110 Issued in PA

Practice address

1310 Silverwood LN
Erie, PA 16505-5208

Phone

(814) 838-4252

NPI assigned

Aug 5, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Leslie Anne Agens Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1285890533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 SILVERWOOD LN",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165055208",
            "telephone_number": "814-838-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SILVERWOOD LN",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165055208",
            "telephone_number": "814-838-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "LESLIE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN279110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "AGENS",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Ann Rupp, MSLP-CCC
• Craig Rush, D.O.
• Sheryl Ann Russ, D.O.
• Ashley Russell
• Claudia Russell, OTR
• Melissa Ann Russiano, L.C.S.W.
• Mary Bertha Russo-Colt, DO
• David Scott Russo
• Mary Frances Russo, PH.D.
• Stephanie F Russo, MD

• Licensed Practical Nurse in Erie, PA
• Providers in Erie, PA by specialty
• Licensed Practical Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.