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Individual

MRS. CIE RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1000 FM 300, LEVELLAND, TX 79336-6235
(806) 894-7842
Mailing address
1000 FM 300, LEVELLAND, TX 79336-6235
(806) 894-7842

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP140210
TX
363LP0200X
Pediatric Nurse Practitioner
AP140210
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
772532
TEXAS BOARD OF NURSING- RN LICENSURE
TX
01
AP140210
TEXAS BOARD OF NURSING- PEDIATRIC NURSE PRACTITIONER LICENSURE
TX
Enumeration date
05/16/2019
Last updated
04/08/2025
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