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Individual
RUSSELL STOREY BOND
Active
Individual
RUSSELL STOREY BOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN 159090
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
AP120634
TX
367500000X
Certified Registered Nurse Anesthetist
APN 14177
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08501017
—
MS
01
—
1134367600
CHAMPUS/HUMANA TRICARE
TN
05
—
1513757
—
TN
05
—
186288001
—
AR
05
—
287097401
—
TX
05
—
287097402
—
TX
01
—
4223159
BLUE CROSS
TN
01
—
8130UC
BCBS
TX
01
—
P00750398
RAILROAD MEDICARE
TN
01
—
P00988004
RAILROAD MEDICARE
TX
Enumeration date
01/21/2009
Last updated
07/21/2020
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