THEODORIA RUSS STNA NPI 1417467150

NPI Information

NPI: 1417467150
Provider Name: THEODORIA RUSS, STNA
Classification: Home Health Aide - 374U00000X
Entity Type: Individual
Address:
349 CABOT ST
YOUNGSTOWN, OH
ZIP 44509
Phone: (330) 792-7629
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Theodoria Russ, STNA is a home health aide in Youngstown, OH. The provider is a person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. Theodoria Russ, STNA NPI is 1417467150. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

349 CABOT ST
YOUNGSTOWN, OH
ZIP 44509-405
Phone: (330) 792-7629
Fax: (330) 782-7858

The enumeration date for this NPI number is 10/9/2017 and was last updated on 10/9/2017.

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	374U00000X	Home Health Aide				Yes
2	374U00000X	Home Health Aide		375819830896	OHIO	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CS1725500	OTHER	OHIO	MY OHIO CARE SOURCE
2	0216072	MEDICAID	OHIO

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: 4/28/2024

NPI Synchronization or Removal

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