Tamela Michelle Russell – Licensed Practical Nurse

Key facts

NPI: 1699424119
Entity type: Individual (NPI type 1)
Primary specialty: Licensed Practical Nurse 164W00000X
License: 0002102131 (VA)
Practice address: 4000 Murray PL
Lynchburg, VA 24501-5004
Phone: (434) 439-3283
NPI assigned: Mar 22, 2022
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Virginia Treatment Center Methadone Clinic · Roanoke, VA · NPI 1811035520

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
0002102131	VA	MD	Licensed Practical Nurse

Practice roles

Organization	Specialty	Status	New patients
Virginia Treatment Center		Past since Mar 27, 2022	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Licensed Practical Nurse	164W00000X	0002102131	VA	Yes

Addresses

Primary practice location

4000 Murray PL
Lynchburg, VA 24501-5004

Mailing address

4000 Murray PL
Lynchburg, VA 24501-5004
Phone (434) 439-3283

Electronic endpoints

Type	Endpoint	Use	Affiliation
CONNECT URL	n

Other providers in Lynchburg, VA

All providers in Lynchburg, VA · Licensed Practical Nurse in Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.