Active NPI
Kristen Russell, PHARM.D.
- Pharmacist
- Jackson, MS
National Provider Identifier
1326440504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E12594
- Practice address
- 6365 I 55 N
Jackson, MS 39213-9742 - Phone
- (601) 718-0021
- NPI assigned
- Sep 19, 2014
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | E12594 | MS | Primary |
Addresses
Primary practice location
6365 I 55 N
Jackson, MS 39213-9742
Mailing address
6365 I 55 N
Jackson, MS 39213-9742
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E12594 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411084800000",
"number": "1326440504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6365 I 55 N",
"city": "JACKSON",
"state": "MS",
"postal_code": "392139742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6365 I 55 N",
"city": "JACKSON",
"state": "MS",
"postal_code": "392139742",
"telephone_number": "601-718-0021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "KRISTEN",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-19",
"last_updated": "2014-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E12594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.