Individual provider Active NPI

Daniella Catherine Russ, APRN

  • Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1336939867
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11038612 Issued in FL
Practice address
2034 SW Beekman St
Port St Lucie, FL 34953-1765
Phone
(772) 207-8828
NPI assigned
May 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11038612 FL
Critical Care Medicine Nurse Practitioner 363LC0200X APRN11038612 FL
Nurse Practitioner 363L00000X APRN11038612 FL Primary
Gerontology Nurse Practitioner 363LG0600X APRN11038612 FL

Addresses

Primary practice location

2034 SW Beekman St
Port St Lucie, FL 34953-1765

Mailing address

2034 SW Beekman St
Port St Lucie, FL 34953-1765
Phone (772) 207-8828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1643 NW 136 Ave
Sunrise, FL 33323-2857

2034 SW Beekman St
Port St Lucie, FL 34953-1765

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11038612FLMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1336939867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2034 SW BEEKMAN ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531765",
            "telephone_number": "772-207-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 SW BEEKMAN ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531765",
            "telephone_number": "772-207-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "DANIELLA",
        "middle_name": "CATHERINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-08",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11038612",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "FL",
            "license": "APRN11038612",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11038612",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11038612",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.