# MRS. SAMARA DEVA RUSSELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1356622120
- **Gender:** F
- **Credential:** APRN, NP-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 004763 | CT | — |
| 363LA2200X | Adult Health Nurse Practitioner | 26NJ0107800 | NJ | Yes |
| 363LG0600X | Gerontology Nurse Practitioner | CAPRN00529 | RI | — |
| 364SX0106X | Occupational Health Clinical Nurse Specialist | 4763 | CT | — |

## Other

- **Enumeration date:** 09/07/2011
- **Last updated:** 08/04/2021