Latonya Michelle Russell, RN

Primary specialty

Wound Care Registered NurseTaxonomy code 163WW0000X

License

28273063A Issued in IN

Practice address

1623 Carolina St
Gary, IN 46407-2346

Phone

(219) 771-0689

NPI assigned

Jan 3, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1417727132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 CAROLINA ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464072346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 CAROLINA ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464072346",
            "telephone_number": "219-771-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "LATONYA",
        "middle_name": "MICHELLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": "IN",
            "license": "28273063A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Jean Royal, FNP
• Ameena R Rucker
• Veronica Ruiz-Avila
• Donna Kay Rush-Lyke
• Amy Russell
• Claudine E Ruzga, P.A.
• Alia Safi, MD
• Kayla Sago, RN
• Ibikunle Salami, DPT
• Gissel Salas, PA-C

• Wound Care Registered Nurse in Gary, IN
• Providers in Gary, IN by specialty
• Wound Care Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.