Andrea Russell, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

017396 Issued in KY

Practice address

4881 Sugar Maple Dr
Wpafb, OH 45433-5529

Phone

(937) 904-0981

NPI assigned

Sep 14, 2010

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

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562976000000",
    "number": "1447568365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15301 WARREN SHINGLE RD",
            "city": "BEALE AFB",
            "state": "CA",
            "postal_code": "959031907",
            "telephone_number": "530-634-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WPAFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-904-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ANDREA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2019-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "017396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dara Daniela Regn, M.D.
• Spencer Renne
• David Riegleman, M.D.
• Caylin Elizabeth Riley, DO
• Melinda Robison
• Benjamin Richard Ryan, M.D.
• Namhun Hana Safranek
• Adam Sanderson, DO
• Ian Christopher Sanford, DO
• Lori A Sansone, M.D.

• Pharmacist in Wpafb, OH
• Providers in Wpafb, OH by specialty
• Pharmacist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2019; 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.