Maegan Renee' Russell, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

204854 Issued in OK

Practice address

1921 Stonecipher Dr
Ada, OK 74820-3439

Phone

(580) 436-3980

NPI assigned

Aug 4, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1376217257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RAY STOUT BLVD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748201908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER DR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203439",
            "telephone_number": "580-436-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MAEGAN",
        "middle_name": "RENEE'",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OK",
            "license": "R0122451",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "204854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Babette S Rossen, CMII
• Justin Kent Roulston, D.O.
• Jessica Rue
• Riley Rush, A.T.C., L.A.T.
• Ericka N Russell, PTA
• Glenene Ruth
• Michelle Elaine Rutherford
• Joel Rutledge, LPC, LADC
• Theodore Mark Rutledge, MD
• Trudy N Rutledge, ICADC

• Family Nurse Practitioner in Ada, OK
• Providers in Ada, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.