Individual
COLLEEN K. RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.P.
Contact information
Practice address
29099 HEALTH CAMPUS DRIVE, SUITE 280, WESTLAKE, OH 44145-4414
(216) 293-0282
(440) 455-9757
Mailing address
29099 HEALTH CAMPUS DRIVE, SUITE 280, WESTLAKE, OH 44145-5200
(216) 293-0282
(440) 455-9757
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0033973
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN.CNP.0033973
OHIO ELICENSURE OHIO PROFESSIONAL LICENSURE/ANCC
OH
01
—
RN.436667
OHIO ELICENSURE OHIO PROFESSIONAL LICENSURE
OH
Enumeration date
10/12/2023
Last updated
01/29/2024
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