Individual
MR. BRIAN D RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
143 LONGWATER DR, NORWELL, MA 02061-1683
(781) 878-5200
(781) 878-6750
Mailing address
319 LINCOLN ST APT 505, HINGHAM, MA 02043-1777
(865) 806-9161
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
14835
TN
363LF0000X
Family Nurse Practitioner
Primary
RN2330343
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1523401
—
TN
05
—
1992021315
—
VA
01
—
P01504956
RAILROAD MEDICARE
VA
Enumeration date
04/09/2010
Last updated
03/06/2020
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