Individual
DR. JENNIFER VERMAELEN RUSS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
136 JEFFERSON DAVIS BLVD, NATCHEZ, MS 39120-5104
(601) 442-5439
(601) 442-3755
Mailing address
PO BOX 17918, NATCHEZ, MS 39122-7918
(601) 442-5439
(601) 442-3755
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
16341
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0121892
—
MS
01
—
1230202
UNITED HEALTHCARE
MS
05
—
1429074
—
LA
01
—
7318135
AETNA
MS
Enumeration date
05/04/2006
Last updated
07/09/2007
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