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Individual

MRS. JASTIN RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BSN, RN-BC

Contact information

Practice address
1878 JEFF RD NW, HUNTSVILLE, AL 35806-4260
(256) 945-7405
Mailing address
424 LAKE HEATHER RESERVE, BIRMINGHAM, AL 35242-7606
(256) 701-7188

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-157898
AL
163WG0100X
Gastroenterology Registered Nurse
1-157898
AL
163WM0705X
Medical-Surgical Registered Nurse
1-157898
AL
363LF0000X
Family Nurse Practitioner
Primary
1-157898
AL
363LX0106X
Occupational Health Nurse Practitioner
1-157898
AL

Other

Enumeration date
04/01/2019
Last updated
01/26/2026
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