Individual
NICHELLE AQUINO RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 539-9582
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 539-9582
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
715252
TX
363L00000X
Nurse Practitioner
Primary
AP125410
TX
Other
Enumeration date
02/27/2014
Last updated
01/22/2026
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