Active NPI
Russell Duale, LPN
- Licensed Practical Nurse
- Fort Rucker, AL
National Provider Identifier
1811393283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 2-063888
- Practice address
- BLDG 301 Andrews Ave
Lyster Army Health Clininc
Fort Rucker, AL 36362 - Phone
- (334) 255-7746
- NPI assigned
- Nov 13, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | 2-063888 | AL | Primary |
Addresses
Primary practice location
BLDG 301 Andrews Ave
Lyster Army Health Clininc
Fort Rucker, AL 36362
Mailing address
301 Andrews Ave
BLDG 301 Lahc BLDG
Fort Rucker, AL 36362
Phone (334) 255-7747
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 |
|---|---|---|---|
| 2-063888 | AL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416787200000",
"number": "1811393283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 ANDREWS AVE",
"address_2": "BLDG 301 LAHC BLDG",
"city": "FORT RUCKER",
"state": "AL",
"postal_code": "36362",
"telephone_number": "334-255-7747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLDG 301 ANDREWS AVE",
"address_2": "LYSTER ARMY HEALTH CLININC",
"city": "FORT RUCKER",
"state": "AL",
"postal_code": "36362",
"telephone_number": "334-255-7746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUALE",
"first_name": "RUSSELL",
"name_prefix": "Mr.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-13",
"last_updated": "2014-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "AL",
"license": "2-063888",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Rucker, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.