Individual
DIANNA DEEN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
308 W 15TH ST, HOPKINSVILLE, KY 42240-2038
(270) 660-8866
Mailing address
308 W 15TH ST, HOPKINSVILLE, KY 42240-2038
(270) 485-8464
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
1157389
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4002146
KY
Other
Enumeration date
08/10/2022
Last updated
06/05/2023
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