Chassidy Mercedes Russell, MSN, APRN, FNP-BC

Individual provider Active NPI Nurse Practitioner · West Point, GA

NPI 1679344089 · NPPES record last updated Mar 31, 2026

Key facts

NPI
1679344089
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
2023127904 (GA)
Practice address
901 Avenue C
West Point, GA 31833-1642
Phone
(762) 209-8009
NPI assigned
Jan 15, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
2023127904GAMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2023127904 GA Yes

Addresses

Primary practice location

901 Avenue C
West Point, GA 31833-1642

Mailing address

4749 Irish Red CT
Union City, GA 30291-3480
Phone (229) 942-5927

Other providers in West Point, GA

All providers in West Point, GA · Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.