Kasey Lynn Russell

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041413115 Issued in IL

Practice address

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Phone

(309) 672-4103

NPI assigned

Aug 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1356829295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N OLIVE ST",
            "city": "WILLIAMSFIELD",
            "state": "IL",
            "postal_code": "614895005",
            "telephone_number": "309-453-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KASEY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-02",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041413115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Ryne Rush, LSW
• Oswarld Niyiduha Irakunda Rusibamayila
• Angelica Rusilowski, DO, MPH
• Lauren Ashley Rusk, MS, RD, LDN
• Brande Ruskusky, CNM, APN
• Kristina R Russell, PT
• Robert Carson Russell, DO
• Sydney Jean Russell, RDN
• Frank Russo, MD
• John C Ruthman, M.D.

• Registered Nurse in Peoria, IL
• Providers in Peoria, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.