Individual
DENIECE RUSSELL-MCADORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6705 W HIGHWAY 290 STE 607, AUSTIN, TX 78735-8408
(512) 843-5169
(512) 856-6238
Mailing address
6705 W HIGHWAY 290 STE 607, AUSTIN, TX 78735-8408
(512) 843-5169
(512) 856-6238
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R874534
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1058694
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02672568
—
MS
Enumeration date
11/14/2013
Last updated
08/19/2024
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