Stacy Lee Russell, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704207197 Issued in MI

Practice address

2850 S Industrial Hwy Ste 50
Ann Arbor, MI 48104-6792

Phone

(734) 477-7228

NPI assigned

Apr 22, 2014

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1760802433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 S INDUSTRIAL HWY STE 50",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046792",
            "telephone_number": "734-477-7228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "STACY",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704207197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith A Russell, PSYCHOLOGIST
• Kathryn Russell, NP
• Mark W Russell, MD
• Montana Skye Russell
• Scott Russell, MD
• Stefanie Rae Russman Block
• Sarah Rose Russman
• Leah C Russo, DNP, RN, WHNP-BC
• Barbara Boyk Rust, PH.D.
• James David Rust, MSW

• Nurse Practitioner in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.