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Individual

NATHAN W RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
166 E MAIN ST, HENDERSONVILLE, TN 37075-2520
(615) 822-3000
(615) 822-0073
Mailing address
166 E MAIN ST, HENDERSONVILLE, TN 37075-2520
(615) 822-3000
(615) 822-0073

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN7542
TN
363L00000X
Nurse Practitioner
RN113668
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3900616 (3159250)
TN
Enumeration date
05/23/2005
Last updated
10/28/2013
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