Individual
DR. THOMAS LEE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, FNP-C, PMHNP-C
Contact information
Practice address
17872 LINCOLN HWY, MIDDLE POINT, OH 45863
(419) 968-2950
Mailing address
10627 CONVOY RD, VAN WERT, OH 45891-9459
(419) 406-0067
(888) 728-4024
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.317795
OH
363L00000X
Nurse Practitioner
APRN.CNP.022944
OH
363LF0000X
Family Nurse Practitioner
APRN.CNP.022944
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.022944
OH
363LP2300X
Primary Care Nurse Practitioner
APRN.CNP.022944
OH
Other
Enumeration date
06/04/2018
Last updated
05/30/2025
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