Individual
MRS. ROSALEE ANN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1009 PENNSYLVANIA AVE, VA CLINIC, OTTUMWA, IA 52501-2108
(641) 683-4300
Mailing address
1009 PENNSYLVANIA AVE, VA CLINIC, OTTUMWA, IA 52501-2108
(641) 683-4300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
072252
IA
363LF0000X
Family Nurse Practitioner
Primary
A072252
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440578
—
IA
01
—
36761
WELLMARK INC BCBS OF IA
IA
01
—
420681060D1
JOHN DEERE HEALTH
IA
01
—
510437
IOWA HEALTH SOLUTIONS
IA
01
—
P00159657
RAILROAD MEDICARE
IA
01
—
UNK
TRIWEST
IA
Enumeration date
08/31/2005
Last updated
06/22/2011
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