Carolyn Vetta Russell, MSN, RN, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

143980 Issued in MS

Practice address

840 N Oak Ave
Ruleville, MS 38771-3227

Phone

(662) 756-2711

Fax

(662) 756-4114

NPI assigned

Oct 4, 2006

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)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

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.

• Advanced Medical Equipment, LLC

  • Durable Medical Equipment & Medical Supplies
  • Clarksdale, MS
  • NPI 1750486049
  NPD (past)
• Advanced Medical Rehabilitation, LLC

  • Family Nurse Practitioner
  • Clarksdale, MS
  • NPI 1831132562

  Family

  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811082191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 GIRL SCOUT RD",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389019283",
            "telephone_number": "662-226-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N OAK AVE",
            "city": "RULEVILLE",
            "state": "MS",
            "postal_code": "387713227",
            "telephone_number": "662-756-2711",
            "fax_number": "662-756-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CAROLYN",
        "middle_name": "VETTA",
        "name_prefix": "Mrs.",
        "credential": "MSN, RN, CFNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "143980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natayla Potts, FNP
• Rohith Guduru Venkata Reddy, MD
• Reflections Adult Daycare & Speciality Services LLC
• Brooks Marlow Rizzo, APRN/ FNP
• Ruleville Dental Clinic
• Saint Anthonys Hospice & Palliative Care
• Saint Johns Hospice& Palliative Care
• Sandanna Hospice, Inc.
• Samuel Dean Seeley, CFNP
• Seniors Medical Equipment

• All providers in Ruleville, MS
• Family Nurse Practitioner in Mississippi

• 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.

Verify at the official NPI Registry.