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Individual
JOY DANAE RUSSELL
Active
Individual
JOY DANAE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
704
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1147592
USA MANAGED CARE
TN
05
—
1520824
—
TN
01
—
4282079
BCBS TN
TN
01
—
8069587
CIGNA
TN
01
—
9862600
AETNA
TN
Enumeration date
07/09/2009
Last updated
07/20/2012
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