Active NPI
Selina Gayle Russell, LPN
- Licensed Practical Nurse
- Prescott, AR
National Provider Identifier
1497778245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- L31721
- Practice address
- 1658 Hwy 371 West
Prescott, AR 71854 - Phone
- (870) 887-3660
- Fax
- (870) 887-3705
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | L31721 | AR | Primary |
Addresses
Primary practice location
1658 Hwy 371 West
Prescott, AR 71854
Mailing address
2904 Arkansas Blvd
Texarkana, AR 71854-2536
Phone (870) 773-4655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L31721 | AR | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497778245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2904 ARKANSAS BLVD",
"city": "TEXARKANA",
"state": "AR",
"postal_code": "718542536",
"telephone_number": "870-773-4655",
"fax_number": "870-772-4650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1658 HWY 371 WEST",
"city": "PRESCOTT",
"state": "AR",
"postal_code": "71854",
"telephone_number": "870-887-3660",
"fax_number": "870-887-3705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "SELINA",
"middle_name": "GAYLE",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "AR",
"license": "L31721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.