JOHANNA MERCEDEZ RUSSELL APRN NPI 1205308640

NPI Information

NPI: 1205308640
Provider Name: JOHANNA MERCEDEZ RUSSELL, APRN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
425 N LEE ST STE 104
JACKSONVILLE, FL
ZIP 32204
Phone: (904) 427-1250
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Johanna Mercedez Russell, APRN is a family nurse practitioner in Jacksonville, FL. Johanna Mercedez Russell, APRN NPI is 1205308640. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

425 N LEE ST STE 104
JACKSONVILLE, FL
ZIP 32204-128
Phone: (904) 427-1250

The NPI 1205308640 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/26/2018 and was last updated on 11/9/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	APRN11001221	FLORIDA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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