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Individual
SHERRI CARLYLE RUSSELL
Active
Individual
SHERRI CARLYLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
28098686A
IN
363LA2200X
Adult Health Nurse Practitioner
71005423A
IN
363LF0000X
Family Nurse Practitioner
Primary
71005423A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000933823
ANTHEM
IN
05
—
201285510
—
IN
Enumeration date
11/20/2014
Last updated
05/07/2021
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