Individual
DENISE L RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3075 US ROUTE 60 STE E540, HUNTINGTON, WV 25705-8859
(304) 528-4600
Mailing address
3075 US ROUTE 60, HUNTINGTON, WV 25705-8859
(304) 528-4600
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
76657
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810019796
—
WV
01
—
P00919108
MEDICARE RAILROAD
—
Enumeration date
11/02/2010
Last updated
04/23/2025
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